Search results for: Maryann Washington

Authors: Dimitrios I. Tselentis, Simon P. Washington

Abstract:

Considerable literature has been focused over the last few decades on forecasting the consumer demand of Energy Efficient Vehicles (EEVs). These methodological issues range from how to capture recent purchase decisions in revealed choice studies and how to set up experiments in stated preference (SP) studies, and choice of analysis method for analyzing such data. This paper reviews the plethora of published studies on the field of forecasting demand of EEVs since 1980, and provides a review and annotated bibliography of that literature as it pertains to this particular demand forecasting problem. This detailed review addresses the literature not only to Transportation studies, but specifically to the problem and methodologies around forecasting to the time horizons of planning studies which may represent 10 to 20 year forecasts. The objectives of the paper are to identify where existing gaps in literature exist and to articulate where promising methodologies might guide longer term forecasting. One of the key findings of this review is that there are many common techniques used both in the field of new product demand forecasting and the field of predicting future demand for EEV. Apart from SP and RP methods, some of these new techniques that have emerged in the literature in the last few decades are survey related approaches, product diffusion models, time-series modelling, computational intelligence models and other holistic approaches.

Keywords: demand forecasting, Energy Efficient Vehicles (EEVs), forecasting methodologies review, methodological approaches

Procedia PDF Downloads 489

Authors: Terefe Alemu

Abstract:

This study is intended to examine Ethiopia’s trade flow determinants and trade potential with G20 countries whether it was overtraded or there is/are trade potential by using trade gravity model. The sources of panel data used were IMF, WDI, United Nations population division, The Heritage Foundation, Washington's No. 1 think tank online website database, online distance calculator, and others for the duration of 2010 to 2019 for 10 consecutive years. The empirical data analyzing tool used was Random effect model (REM), which is effective in estimation of time-invariant data. The empirical data analyzed using STATA software result indicates that Ethiopia has a trade potential with seven countries of G20, whereas Ethiopia overtrade with 12 countries and EU region. The Ethiopia’s and G20 countries/region bilateral trade flow statistically significant/ p<0.05/determinants were the population of G20 countries, growth domestic products of G20 countries, growth domestic products of Ethiopia, geographical distance between Ethiopia and G20 countries. The top five G20 countries exported to Ethiopia were china, United State of America, European Union, India, and South Africa, whereas the top five G20 countries imported from Ethiopia were EU, China, United State of America, Saudi Arabia, and Germany, respectively. Finally, the policy implication were Ethiopia has to Keep the consistence of trade flow with overtraded countries and improve with under traded countries through trade policy revision, and secondly, focusing on the trade determinants to improve trade flow is recommended.

Keywords: trade gravity model, trade determinants, G20, international trade, trade potential

Procedia PDF Downloads 214

Authors: Saidu Garba Okereafor Stella

Abstract:

The presence of 15 organochlorine pesticides residue was assessed from 29 different fruits and fruit juice samples from selected farms in Kaduna and Niger States using the quick easy cheap effective rugged and safe (QuEChERS), followed by gas chromatography-tandem mass spectrometry (GC-MS/MS). The results showed the presence of varying concentrations of ten (10) organochlorine pesticide residues in all the samples with Endrin ketone showing the highest concentration in 3 samples from Kaduna (guava juice 1 and 2 0.099 to 0.145 mg/kg) and Niger States (orange juice J19 0.102 mg/kg). The heptachlor was detected at high concentration in 11 samples, 7 samples from Kaduna State (mango juice 0.011 mg/kg, Washington orange 0.014 mg/kg, Valencia orange fruit 0.020 mg/kg, orange juice 0.011, white guava fruit 0.024 mg/kg, guava juice 0.023 mg/kg, guava juice 2 0.024 mg/kg) and 4 samples from (mango juice 1 0.015 mg/kg, pineapple juice 1 0.0120 mg/kg pineapple juice 2 011 mg/kg and mix juice 2 0.012 mg/kg) from Niger State. Dieldrine and endosulfansulfate were detected at high levels in one sample each from Niger (guava fruit 0.019 mg/kg and mixed juice1 0.011mg/kg), respectively. However, all were above the maximum residue limits (MRLs) set by WHO/FAO which suggest that people consuming these type of contaminated fruits and fruits juices may contact diseases associated with those organochlorine pesticides residue. Minute concentrations of other organochlorines (α- BHC, δ- BHC, β- BHC, Lindane, and p’p DDT) ranged from 0.003 to 0.015 were recorded below the MRLs.

Keywords: fruits and fruits juices, organochlorine pesticide residue, comparative studies, gc-ms spectrophometer

Procedia PDF Downloads 147

Authors: Kristen Erekson, Sarah Spendlove Caswell

Abstract:

Nurse educators have the challenge of training future nurses that will provide compassionate care to an increasingly diverse population of patients in a culturally sensitive way. One approach to this challenge is an immersive public and global health experience as part of the nursing program curriculum. Undergraduate nursing students at our institution are required to participate in a Public and Global Health course. They participate in a didactic preparatory course followed by a 3-to-4-week program in one of the following locations: The Czech Republic, Ecuador, Finland/Poland, Ghana, India, Spain, Taiwan, Tonga, an Honor Flight to Washington D.C. with Veterans, or in local (Utah) communities working with marginalized populations (including incarcerated individuals, refugees, etc.). The students are required to complete 84 clinical hours and 84 culture hours (which involve exposure to local history, art, architecture, customs, etc.). As Faculty, we feel strongly that these public and global health experiences help cultivate cultural awareness in our students and prepare nurses who are better prepared to serve a diverse population of patients throughout their careers. This presentation will highlight our experiences and provide ideas for other nurse educators who have an interest in developing similar programs in their schools but do not know where to start. Suggestions about how to start building relationships that can lead to these opportunities, along with logistics for continuing the programs, will be highlighted.

Keywords: global health nursing, nursing education, clinical education, public health nursing

Procedia PDF Downloads 78

Authors: Achim Washington, Reece Clothier, Jose Silva

Abstract:

System Safety Regulations (SSR) are a central component to the airworthiness certification of Unmanned Aircraft Systems (UAS). There is significant debate on the setting of appropriate SSR for UAS. Putting this debate aside, the challenge lies in how to apply the system safety process to UAS, which lacks the data and operational heritage of conventionally piloted aircraft. The limited knowledge and lack of operational data result in uncertainty in the system safety assessment of UAS. This uncertainty can lead to incorrect compliance findings and the potential certification and operation of UAS that do not meet minimum safety performance requirements. The existing system safety assessment and compliance processes, as used for conventional piloted aviation, do not adequately account for the uncertainty, limiting the suitability of its application to UAS. This paper discusses the challenges of undertaking system safety assessments for UAS and presents current and envisaged research towards addressing these challenges. It aims to highlight the main advantages associated with adopting a risk based framework to the System Safety Performance Requirement (SSPR) compliance process that is capable of taking the uncertainty associated with each of the outputs of the system safety assessment process into consideration. Based on this study, it is made clear that developing a framework tailored to UAS, would allow for a more rational, transparent and systematic approach to decision making. This would reduce the need for conservative assumptions and take the risk posed by each UAS into consideration while determining its state of compliance to the SSR.

Keywords: Part 1309 regulations, risk models, uncertainty, unmanned aircraft systems

Procedia PDF Downloads 187

Authors: Bongs Lainjo

Abstract:

The evolution and escalation of bike-sharing programs (BSP) continue unabated. Since the sixties, many countries have introduced different models and strategies of BSP. These include variations ranging from dockless models to electronic real-time monitoring systems. Reasons for using this BSP include recreation, errands, work, etc. And there is all indication that complex, and more innovative rider-friendly systems are yet to be introduced. The objective of this paper is to analyze current variables established by different operators and streamline them identifying the most compelling ones using analytics. Given the contents of available databases, there is a lack of uniformity and common standard on what is required and what is not. Two factors appear to be common: user type (registered and unregistered, and duration of each trip). This article uses historical data provided by one operator based in the greater Washington, District of Columbia, USA area. Several variables including categorical and continuous data types were screened. Eight out of 18 were considered acceptable and significantly contribute to determining a useful and reliable predictive model. Bike-sharing systems have become popular in recent years all around the world. Although this trend has resulted in many studies on public cycling systems, there have been few previous studies on the factors influencing public bicycle travel behavior. A bike-sharing system is a computer-controlled system in which individuals can borrow bikes for a fee or free for a limited period. This study has identified unprecedented useful, and pragmatic parameters required in improving BSP ridership dynamics.

Keywords: sharing program, historical data, parameters, ridership dynamics, trip duration

Procedia PDF Downloads 138

Authors: Joseph Sello Kau, Elias Mashayamombe, Brian Washington Madinkana, Cynthia Ngwane

Abstract:

This paper presents the results for the statistical (stepwise linear regression and multiple regression) analyses, carried out on a number of crops in order to evaluate how the decision for crop choice affect the level of farm income generated by the farmers participating in the High Value Crop production (referred to as the HVC). The goal of the HVC is to encourage farmers cultivate fruit crops. The farmers received planting material from different extension agencies, together with other complementary packages such as fertilizer, garden tools, water tanks etc. During the surveys, it was discovered that a significant number of farmers were cultivating traditional crops even when their plot sizes were small. Traditional crops are competing for resources with high value crops. The results of the analyses show that farmers cultivating fruit crops, maize and potatoes were generating high income than those cultivating spinach and cabbage. High farm income is associated with plot size, access to social grants and gender. Choice for a crop is influenced by the availability of planting material and the market potential for the crop. Extension agencies providing the planting materials stand a good chance of having farmers follow their directives. As a recommendation, for the farmers to cultivate more of the HVCs, the ARC must intensify provision of fruit trees.

Keywords: farm income, nature of extension services, type of crops cultivated, fruit crops, cabbage, maize, potato and spinach

Procedia PDF Downloads 323

Authors: Fakhrullah Sarwari, Hiroko Ono

Abstract:

Kabul city has suffered a lot in 40 years of conflict of civil war and “The war on terror”. After the invasion of Afghanistan by the United States of America and its allies in 2001, the Taliban was removed from operational power, but The Taliban and other terrorist groups remained in remote areas of the country, they started suicide attacks and bombings. Hence to protect from these attacks officials surrounded their office buildings and houses with concrete blast walls. It gives a bad landscape to the city and creates traffic congestions. Our research contains; questionnaire, reviewing Kabul Municipality documents and literature review. Questionnaires were distributed to Kabul citizens to find out how people feel by seeing the T-Walls on Kabul streets? And what problems they face with T-Walls. “The T-Walls pull down commission” of Kabul Municipality documents were reviewed to find out what caused the failure of this commission. A literature review has been done to compare Kabul with Washington D.C on how they designed the city against terrorism threat without turning the cities into lock down. Bogota city of Columbia urban happiness movement is reviewed and compared with Kabul. The finding of research revealed that citizens of Kabul want security but not at the expense of public realm and creating the architecture of fear. It also indicates that increasing the T-walls do not give secure feeling but instead; it increases terror, hatred and affect people’s optimism. At the end, a series of recommendation is suggested on the issue.

Keywords: anti-terror design, Kabul, T-Walls, urban happiness

Procedia PDF Downloads 170

Authors: Md. Mahadi Hasan Sany, Mumenunnessa Keya, Sharun Khushbu, Sheikh Abujar

Abstract:

Since the beginning of China's economic reform, trade between the U.S. and China has grown rapidly, and has increased since China's accession to the World Trade Organization in 2001. The US imports more than it exports from China, reducing the trade war between China and the U.S. for the 2019 trade deficit, but in 2020, the opposite happens. In international and U.S. trade, Washington launched a full-scale trade war against China in March 2016, which occurred a catastrophic epidemic. The main goal of our study is to measure and predict trade relations between China and the U.S., before and after the arrival of the COVID epidemic. The ML model uses different data as input but has no time dimension that is present in the time series models and is only able to predict the future from previously observed data. The LSTM (a well-known Recurrent Neural Network) model is applied as the best time series model for trading forecasting. We have been able to create a sustainable forecasting system in trade between China and the US by closely monitoring a dataset published by the State Website NZ Tatauranga Aotearoa from January 1, 2015, to April 30, 2021. Throughout the survey, we provided a 180-day forecast that outlined what would happen to trade between China and the US during COVID-19. In addition, we have illustrated that the LSTM model provides outstanding outcome in time series data analysis rather than RFR and SVR (e.g., both ML models). The study looks at how the current Covid outbreak affects China-US trade. As a comparative study, RMSE transmission rate is calculated for LSTM, RFR and SVR. From our time series analysis, it can be said that the LSTM model has given very favorable thoughts in terms of China-US trade on the future export situation.

Keywords: RFR, China-U.S. trade war, SVR, LSTM, deep learning, Covid-19, export value, forecasting, time series analysis

Procedia PDF Downloads 198

Authors: K. M. Wong

Abstract:

Engineering education is crucial to technological innovation and advancement worldwide by generating young talents who are able to integrate scientific principles and design practical solutions for real-world problems. Graduates of engineering curriculums are expected to demonstrate an extensive set of learning outcomes as required in international accreditation agreements for engineering academic qualifications, such as the Washington Accord and the Sydney Accord. On the other hand, students have different learning preferences of receiving, processing and internalizing knowledge and skills. If the learning environment is advantageous to the learning styles of the students, there is a higher chance that the students can achieve the intended learning outcomes. With proper identification of the learning styles of the students, corresponding teaching strategies can then be developed for more effective learning. This research was an investigation of learning styles of tertiary students studying higher diploma programmes in Hong Kong. Data from over 200 students in engineering programmes were collected and analysed to identify the learning characteristics of students. A small-scale longitudinal study was then started to gather academic results of the students throughout their two-year engineering studies. Preliminary results suggested that the sample students were reflective, sensing, visual, and sequential learners. Observations from the analysed data not only provided valuable information for teachers to design more effective teaching strategies, but also provided data for further analysis with the students’ academic results. The results generated from the longitudinal study shed light on areas of improvement for more effective engineering curriculum design for better teaching and learning.

Keywords: learning styles, learning characteristics, engineering education, vocational education, Hong Kong

Procedia PDF Downloads 264

Authors: Asma Inge-Hanif, Ayyub Ansari Hanif

Abstract:

The impact of conflicts, the subsequent refugee migration to America and their attempted use of societal resources implicate the lack of further humanitarian aid as a consequence of the abrupt decrease in services and policy changes stemming from new governmental mandates and Executive Orders. Statistical research data indicates a substantial decline in access to standardized health services by refugee women creating a significant alteration in the management of their maternal health care in America, previously shown to result in decreased mortality and morbidity. Studying nursing at Howard University in Washington, D.C., observed doctors were not always sensitive to the needs and modesty concerns of immigrant Muslim women - often unintentionally. Among health care professionals, the prevailing belief should be that every man, woman and child has the right to quality care in a dignified manner and the achievement of optimal health and well-being, regardless of race, creed, socio-economic level or status. In 1987 Muslimat Al Nisaa Health and Social Services Center was established to care for underserved and uninsured women and children. This Center, plus the subsequent shelter, provided direct access to those homeless, refugees, human trafficking and women victims of domestic violence was established and provides the data for this study. Understanding specific culture, social, economic and religious nuances respects their diversity and addressing their basic human needs that they achieve optimal success. The ultimate goal being to facilitate the rescue and housing of those whom escaped from a country/communities where girls are devalued, brought, sold and abused.

Keywords: women, refugee, domestic violence, health care

Procedia PDF Downloads 89

Authors: Dmytro Zubov, Francesco Volponi

Abstract:

In this paper, D-Wave quantum computing Ising model is used for the forecasting of positive extremes of daily mean air temperature. Forecast models are designed with two to five qubits, which represent 2-, 3-, 4-, and 5-day historical data respectively. Ising model’s real-valued weights and dimensionless coefficients are calculated using daily mean air temperatures from 119 places around the world, as well as sea level (Aburatsu, Japan). In comparison with current methods, this approach is better suited to predict heat wave values because it does not require the estimation of a probability distribution from scarce observations. Proposed forecast quantum computing algorithm is simulated based on traditional computer architecture and combinatorial optimization of Ising model parameters for the Ronald Reagan Washington National Airport dataset with 1-day lead-time on learning sample (1975-2010 yr). Analysis of the forecast accuracy (ratio of successful predictions to total number of predictions) on the validation sample (2011-2014 yr) shows that Ising model with three qubits has 100 % accuracy, which is quite significant as compared to other methods. However, number of identified heat waves is small (only one out of nineteen in this case). Other models with 2, 4, and 5 qubits have 20 %, 3.8 %, and 3.8 % accuracy respectively. Presented three-qubit forecast model is applied for prediction of heat waves at other five locations: Aurel Vlaicu, Romania – accuracy is 28.6 %; Bratislava, Slovakia – accuracy is 21.7 %; Brussels, Belgium – accuracy is 33.3 %; Sofia, Bulgaria – accuracy is 50 %; Akhisar, Turkey – accuracy is 21.4 %. These predictions are not ideal, but not zeros. They can be used independently or together with other predictions generated by different method(s). The loss of human life, as well as environmental, economic, and material damage, from extreme air temperatures could be reduced if some of heat waves are predicted. Even a small success rate implies a large socio-economic benefit.

Keywords: heat wave, D-wave, forecast, Ising model, quantum computing

Procedia PDF Downloads 499

Authors: Cody Stolle, Mojdeh Asadollahipajouh, Khaleb Pafford, Jada Iwuoha, Samantha White, Becky Mueller

Abstract:

Battery-electric vehicles (BEVs) are growing in sales and popularity in the United States as an alternative to traditional internal combustion engine vehicles (ICEVs). BEVs are generally heavier than corresponding models of ICEVs, with large battery packs located beneath the vehicle floorpan, a “skateboard” chassis, and have front and rear crush space available in the trunk and “frunk” or front trunk. The geometrical and frame differences between the vehicles may lead to incompatibilities with gasoline vehicles during vehicle-to-vehicle crashes as well as run-off-road crashes with roadside barriers, which were designed to handle lighter ICEVs with higher centers-of-mass and with dedicated structural chasses. Crash data were collected from 10 states spanning a five-year period between 2017 and 2021. Vehicle Identification Number (VIN) codes were processed with the National Highway Traffic Safety Administration (NHTSA) VIN decoder to extract BEV models from ICEV models. Crashes were filtered to isolate only vehicles produced between 2010 and 2021, and the crash circumstances (weather, time of day, maximum injury) were compared between BEVs and ICEVs. In Washington, 436,613 crashes were identified, which satisfied the selection criteria, and 3,371 of these crashes (0.77%) involved a BEV. The number of crashes which noted a fire were comparable between BEVs and ICEVs of similar model years (0.3% and 0.33%, respectively), and no differences were discernable for the time of day, weather conditions, road geometry, or other prevailing factors (e.g., run-off-road). However, crashes involving BEVs rose rapidly; 31% of all BEV crashes occurred in just 2021. Results indicate that BEVs are performing comparably to ICEVs, and events surrounding BEV crashes are statistically indistinguishable from ICEV crashes.

Keywords: battery-electric vehicles, transportation safety, infrastructure crashworthiness, run-off-road crashes, ev crash data analysis

Procedia PDF Downloads 89

Authors: Mahdi Akhbardeh

Abstract:

St John's wort plant can help to treat depression disease through decreasing this disease symptom, due to having some similar features of Prozac (Fluoxetine Hcl) pill. People suffering from slight depression who have fear of using antidepressants side effects can use St John's wort drops under doctor observation. This method of treatment is proposed specially to those women who are spending menopause or depression resulted from this period. St John's wort plant have proposed traditional and plant medicine as newest researches in treating mood disorders compared to Prozac (Fluoxetine Hcl) drug in treating depression disease which is being administrated in clinic research center of Washington. Objective: the aim of this study is to find an alternative treatment method in people suffering from depression which are treated with Prozac (Fluoxetine Hcl). Almost 70 percent of treatment failures with Prozac (Fluoxetine Hcl) drug in patients suffering from slight to normal depression is due to intensive side effects including: decrease in blood pressure, reduce in sexual desire and 30 percent of it is due to this drug affectless in treatment procedure which leads to leaving treatment. Results of Hypercuim plant function are exactly similar to antidepressants. Increase in serotonin amount in brain synopsis terminal end causes increase in existence time of this material in this part. In fact these two drugs have similar function. Though side effects of Hypercuim plant(St John's wort) including headache and slight nausea tolerable. Results: St John's wort plant can be used lonely in slight to normal depressions in which patients are avoiding Prozac (Fluoxetine Hcl) drug due to it's side effects. In intensive depressions through which general patients don’t indicate positive response to drug, it is probably expected relative or even complete treatment through combining antidepressants drugs with this plant. This treatment method has been investigated and confirmed in clinical tests and researches.

Keywords: depression, St John's wort, Prozac, antidepressant

Procedia PDF Downloads 488

Authors: Hsiao-ting Lin

Abstract:

This paper analyzes the history of Taiwan’s secret program to develop its nuclear weapons during the Cold War. In July 1971, US President Richard Nixon shocked the world when he announced that his national security adviser Henry Kissinger had made a secret trip to China and that he himself had accepted an invitation to travel to Beijing. This huge breakthrough in the US-PRC relationship was followed by Taipei’s loss of political legitimacy and international credibility as a result of its UN debacle in the fall that year. Confronted with the Nixon White House’s opening to the PRC, leaders in Taiwan felt being betrayed and abandoned, and they were obliged to take countermeasures for the sake of national interest and regime survival. Taipei’s endeavor to create an effective nuclear program, including the possible development of nuclear weapons capabilities, fully demonstrates the government’s resolution to pursue its own national policy, even if such a policy was guaranteed to undermine its relations with the United States. With hindsight, Taiwan’s attempt to develop its own nuclear weapons did not succeed in sabotaging the warming of US-PRC relations. Worse, it was forced to come to a full stop when, in early 1988, the US government pressured Taipei to close related facilities and programs on the island. However, Taiwan’s abortive attempt to develop its nuclear capability did influence Washington’s and Beijing’s handling of their new relationship. There did develop recognition of a common American and PRC interest in avoiding a nuclearized Taiwan. From this perspective, Beijing’s interests would best be served by allowing the island to remain under loose and relatively benign American influence. As for the top leaders on Taiwan, such a policy choice demonstrated how they perceived the shifting dynamics of international politics in the 1960s and 1970s and how they struggled to break free and pursue their own independent national policy within the rigid framework of the US-Taiwan alliance during the Cold War.

Keywords: taiwan, richard nixon, nuclear program, chiang Kai-shek, chiang ching-kuo

Procedia PDF Downloads 131

Authors: Toufic Sarieddine

Abstract:

As the belt and road Initiative (henceforth, BRI) enters its 9th year, Iran and China are forging stronger ties on economic and military fronts, a development which has not only caused alarm in Washington but also risks staining China’s relationships with the oil-rich Gulf monarchies. World-systems theory has been used to examine the impact of the BRI on the current world order, with scholarship split on the capacity of China to emerge as a hegemon contending with the US or even usurping it. This paper argues the emergence of a new China-centered world-system comprised of states/areas and processes participating in the BRI and overlapping with the global world-system under (shaky) US hegemony. This world-system centers around China as core and hegemon via economic domination, capable new institutions (Shanghai Cooperation Council), legal modi operandi, the common goal of infrastructure development to rally support among developing states, and other indicators of hegemony outlined in world-systems theory. In this regard, while states like Pakistan could become peripheries to China in the BRI-bound world-system via large-scale projects such as the China-Pakistan Economic Corridor, Iran has greater capacities and influence in the Middle East, making it superior to a periphery. This paper thus argues that the increasing proximity between Iran and China sees the former becoming a semi-periphery with respect to China within the BRI-bound world-system, having economic dependence on its new core and hegemon while simultaneously wielding political and military influence on weaker states such as Iraq, Lebanon, Yemen, and Syria. The indicators for peripheralization as well as the characteristics of a semi-periphery outlined in world-systems theory are used to examine the current economic, political, and militaristic dimensions of Iran and China’s growing relationship, as well as the trajectory of these dimensions as part of the BRI-bound world-system.

Keywords: belt and road initiative, China, China-Middle East relations, Iran, world-systems analysis

Procedia PDF Downloads 155

Authors: Theodore Panton

Abstract:

As cities in the United States experience critical housing shortages, mass timber presents the opportunity to address this crisis in housing supply while taking advantage of the carbon-positive benefits of sustainably forested wood fiber. Mass timber, however, currently has a low level of adoption in residential multifamily structures due to the risk-averse nature of change within the construction financing, Architecture / Engineering / Contracting (AEC) communities, as well as various agency approval challenges. This study demonstrates how mass timber can be used within the cost and feasibility parameters of a typical multistory residential structure and ultimately address the need for dense urban housing. This study will utilize The Garden District, a mixed-use market-rate housing project in Woodinville, Washington, as a case study to illuminate the potential of mass timber in this application. The Garden District is currently in final stages of permit approval and will commence construction in 2023. It will be the tallest dowel-laminated timber (DLT) residential structure in the United States when completed. This case study includes economic, technical, and design reference points to demonstrate the relevance of the use of this system and its ability to deliver “triple bottom line” results. In terms of results, the study establishes scalable and repeatable approaches to project design and delivery of mass timber in multifamily residential uses and includes economic data, technical solutions, and a summary of end-user advantages. This study discusses the third party tested systems for satisfying acoustical requirements within dwelling units, a key to resolving the use of mass timber within multistory residential use. Lastly, the study will also compare the mass timber solution with a comparable cold formed steel (CFS) system with a similar program, which indicates a net carbon savings of over three million tons over the life cycle of the building.

Keywords: DLT, dowell laminated timber, mass timber, market rate multifamily

Procedia PDF Downloads 121

Authors: Pankaj Pradhananga

Abstract:

Inclusive Tourism is a relatively new topic in Nepal. Though the effort of creating accessible and inclusive tourism has already begun, it is still in its infancy. A major concern for Destination Nepal is the lack of awareness and absence of mandatory law in place to encourage Tourism operating sectors for coming up with accessible Tourism products. Given the number economic and social benefits to may be derived from inclusive tourism, it is a critical time for the tourism industry to understand and develop measures towards inclusivity in the gateway to Himalaya. Nepal was struck with a devastating earthquake on April 25th, 2015 which concurrently left more than 4,000 Nepalese with physical disabilities. Nepal has had to rebuild and is continuing to rebuild a lot of infrastructure and the process of rebuilding should be barrier free and use universal design measures. With universal design in place, this would allow access for minority groups such as people with disabilities and the elderly to the historic monuments in Kathmandu valley. Four Seasons Travel ( 4ST) has been a key player in not only creating accessible tourism experiences in Nepal, but also promoting accessible tourism to other tourism operators. Dr. Scott Rains had worked closely with 4ST on accessible tourism. Additionally, it organised an accessible trek which was field tested with a traveler with vision impairment in August 2015. Another accessible trekking experience, in partnership with Washington DC based International Development Institute, was coined as ‘Wounded Heroes Trek to Nepal’, where a group of Veterans that are amputees went trekking in the Annapurna Region. The event made it to the list of UNWTO World Tourism Day celebrations. Such initiatives led by private sector in partnership with various organizations have worked to create a ‘Destination Nepal for all’. However, there is still a lot of work that needs to be done to make Nepal a truly inclusive destination. Partnerships between the private sector and DPOs ( Disabled People’s Organizations) as well as the government are also a sound opportunity for employment creation for people with disabilities. Further, partnerships between the state, tourism service providers and DPOs need to be fostered to create job opportunities for people with disabilities. This can be exemplified through the social Entrepreneurship model with the help of accessible Tourism.

Keywords: accessible tourism, disability, earthquake, inclusion

Procedia PDF Downloads 472

Authors: Daniel Osieko Okach, Joseph Otieno Ondier, Gerhard Rambold, John Tenhunen, Bernd Huwe, Dennis Otieno

Abstract:

Increased human activities such as grazing, logging, and agriculture alongside unpredictable rainfall patterns have been detrimental to the ecosystem service delivery, therefore compromising its productivity potential. This study aimed at simulating the impact of drought (50%) and enhanced rainfall (150%) on the future herbaceous CO2 uptake, biomass production and soil C:N dynamics in a humid savanna ecosystem influenced by livestock grazing. Rainfall pattern was predicted using manipulation experiments set up to reduce (50%) and increase (150%) ambient (100%) rainfall amounts in grazed and non-grazed plots. The impact of manipulated rainfall regime on herbaceous CO2 fluxes, biomass production and soil C:N dynamics was measured against volumetric soil water content (VWC) logged every 30 minutes using the 5TE (Decagon Devices Inc., Washington, USA) soil moisture sensors installed (at 20 cm soil depth) in every plots. Herbaceous biomass was estimated using destructive method augmented by standardized photographic imaging. CO2 fluxes were measured using the ecosystem chamber method and the gas analysed using LI-820 gas analyzer (USA). C:N ratio was calculated from the soil carbon and Nitrogen contents (analyzed using EA2400CHNS/O and EA2410 N elemental analyzers respectively) of different plots under study. The patterning of VWC was directly influenced by the rainfall amount with lower VWC observed in the grazed compared to the non-grazed plots. Rainfall variability, grazing and their interaction significantly affected changes in VWC (p < 0.05) and subsequently total biomass and CO2 fluxes. VWC had a strong influence on CO2 fluxes under 50% rainfall reduction in the grazed (r2 = 0.91; p < 0.05) and ambient rainfall in the ungrazed (r2 = 0.77; p < 0.05). The dependence of biomass on VWC across plots was enhanced under grazed (r2 = 0.78 - 0.87; p < 0.05) condition as compared to ungrazed (r2 = 0.44 - 0.85; p < 0.05). The C:N ratio was however not correlated to VWC across plots. This study provides insight on how the predicted trends in humid savanna will respond to changes influenced by rainfall variability and livestock grazing and consequently the sustainable management of such ecosystems.

Keywords: CO2 fluxes, rainfall manipulation, soil properties, sustainability

Procedia PDF Downloads 133

Authors: Abimbola Akintounde

Abstract:

Supporting the social and emotional needs of young adolescents has become an emergent concern for schools around the world. Yet educators remain in a dilemma regarding the optimum approach for integrating social and emotional learning (SEL) into their content area instruction. The purpose of this study was to explore the perception of secondary students regarding their schoolwide SEL interventions. Twenty-four International Baccalaureate students in a final year mathematics course at an American Public Secondary School near Washington D. C. were randomly selected for participation in this study via an online electronic survey. The participants in this study used Likert-scale items to rate the effectiveness of the socio-emotional and character development programs being implemented at their schools. Respondents also ranked their preferred mode of delivery of social and emotional support programs. About 71% of the teenagers surveyed preferred SEL support rendered via interactive team-building activities and games, 42% of the high school students in the study ranked focus group discussions as their preferred format for SEL interventions, while only 13% of the respondents in the study regarded lectures and presentations as their preferred mode of SEL delivery. About one-fourth of the study participants agreed that explicit instruction was critical to enhancing students’ wellness, 79% agreed that SEL programs should foster less teacher talk, while 88% of the students indicated that student engagement was critical to their mental health. Eighty percent of the teenagers surveyed decried that the focus of their school-wide social and emotional programs was poorly prioritized. About two-thirds of the students agreed that social justice and equity issues should be embedded in their schools’ advisory programs. More than half of the respondents agitated for strategies for managing stress and their school workload. About 54% of the respondents also clamored for SEL programs that reinforce emotion regulation and coping strategies for anxiety. Based on the findings of this study, recommendations were proffered for best practices in the design and implementation of effective learner-friendly social and emotional development interventions.

Keywords: SEL, math anxiety, student support, emotion regulation, social awareness, self awareness, self management, relationship building

Procedia PDF Downloads 73

Authors: Matt S. Van Deren, Michael Papenfus

Abstract:

Seattle is one of the hundreds of cities in the United States that relies on a combined sewer system to collect and convey municipal wastewater. By design, these systems convey all wastewater, including industrial and commercial wastewater, human sewage, and stormwater runoff, through a single network of pipes. Serious problems arise for combined sewer systems during heavy precipitation events when treatment plants and storage facilities are unable to accommodate the influx of wastewater needing treatment, causing the sewer system to overflow into local waterways through sewer outfalls. CSOs (Combined Sewer Overflows) pose a serious threat to human and environmental health. Principal pollutants found in CSO discharge include microbial pathogens, comprising of bacteria, viruses, parasites, oxygen-depleting substances, suspended solids, chemicals or chemical mixtures, and excess nutrients, primarily nitrogen and phosphorus. While concentrations of these pollutants can vary between overflow events, CSOs have the potential to spread disease and waterborne illnesses, contaminate drinking water supplies, disrupt aquatic life, and effect a waterbody’s designated use. This paper estimates the economic impact of CSOs on residential property values. Using residential property sales data from Seattle, Washington, this paper employs a hedonic valuation model that controls for housing and neighborhood characteristics, as well as spatial and temporal effects, to predict a consumer’s willingness to pay for improved water quality near their homes. Initial results indicate that a 100,000-gallon decrease in the average annual overflow discharged from a sewer outfall within 300 meters of a home is associated with a 0.053% increase in the property’s sale price. For the average home in the sample, the price increase is estimated to be $18,860.23. These findings reveal some of the important economic benefits of improving water quality by reducing the frequency and severity of combined sewer overflows.

Keywords: benefits, hedonic, Seattle, sewer

Procedia PDF Downloads 177

Authors: Christine Eickhoff, Alyssa Adams, Alaine Duncan

Abstract:

The Washington, DC Veterans Affairs Medical Center (DC VAMC) offers complementary and integrative health (CIH) services such as acupuncture, yoga, meditation, and nutrition education through a coordinated outpatient clinic. The primary population utilizing CIH services are veterans with chronic pain. Acupuncture is one of the most popular of the CIH services available at the DC VAMC. As interest and availability grows, it is important to measure health outcomes associated with CIH service utilization. The purpose of this study was to investigate pain and mental health outcomes for veterans with chronic pain enrolled in individual acupuncture services in the DC VAMC. Veterans at the DC VAMC with self-identified chronic pain and no prior acupuncture experience were recruited for the study (n=70). Veterans were referred for services by a medical provider and completed baseline assessments at the program orientation prior to participating in any CIH services. Veterans received four individual, full-body acupuncture appointments within four weeks of study enrollment. After the first month, participants were scheduled for six appointments that occurred every two weeks and then eight more sessions that were scheduled one month apart. Follow-up assessments were administered at 2, 4, 6, 8, and 12 months. The findings reported will include completed time points at two and four months. Measures include a demographics survey, the Measure Yourself Medical Outcome Profile-2 (MYMOP-2), The Beck Depression Inventory (BDI-II), the Defense Veterans Pain Rating Scale (DVPRS), and the Pain Disability Questionnaire (PDQ). In this sample, 67% identified a pain condition as their primary health concern. Between baseline and two-month follow-up, there were significant improvements in participants’ primary health concern (MYMOP-2 p=0.010), general wellbeing (MYMOP-2 p=0.011), and a significant decrease in the use of medication (MYMOP-2 p<0.000). Between 2 and 4-month follow-up, pain disability (PDQ p=0.035), pain rating (DVPRS p=0.027), and depression (BDI-II p=0.003) significantly improved. Preliminary findings indicate that individual acupuncture therapy can be effective at improving health outcomes, well-being, and decreasing medication use in U.S. military veterans with chronic pain. Findings also suggest that individual acupuncture therapy can improve pain ratings, pain disability, and depression in veterans with chronic pain.

Keywords: acupuncture, chronic pain, depression, integrative health, medication use, military, pain, veterans, wellbeing

Procedia PDF Downloads 256

Authors: S. Murr, S. Phillips

Abstract:

One of the biggest challenges entering a market with a carsharing or any other shared mobility (SM) service is sound investment decision-making. To support this process, the authors think that a city index evaluating different criteria is necessary. The goal of such an index is to benchmark cities along a set of external measures to answer the main two challenges: financially viability and the understanding of its specific requirements. The authors have consulted several shared mobility projects and industry experts to create such a Shared Mobility City Index (SMCI). The current proposal of the SMCI consists of 11 individual index measures: general data (demographics, geography, climate and city culture), shared mobility landscape (current SM providers, public transit options, commuting patterns and driving culture) and political vision and goals (vision of the Mayor, sustainability plan, bylaws/tenders supporting SM). To evaluate the suitability of the index, 16 cities on the East Coast of North America were selected and secondary research was conducted. The main sources of this study were census data, organisational records, independent press releases and informational websites. Only non-academic sources where used because the relevant data for the chosen cities is not published in academia. Applying the index measures to the selected cities resulted in three major findings. Firstly, density (city area divided by number of inhabitants) is not an indicator for the number of SM services offered: the city with the lowest density has five bike and carsharing options. Secondly, there is a direct correlation between commuting patterns and how many shared mobility services are offered. New York, Toronto and Washington DC have the highest public transit ridership and the most shared mobility providers. Lastly, except one, all surveyed cities support shared mobility with their sustainability plan. The current version of the shared mobility index is proving a practical tool to evaluate cities, and to understand functional, political, social and environmental considerations. More cities will have to be evaluated to refine the criteria further. However, the current version of the index can be used to assess cities on their suitability for shared mobility services and will assist investors deciding which city is a financially viable market.

Keywords: carsharing, transportation, urban planning, shared mobility city index

Procedia PDF Downloads 303

Authors: Praniil Nagaraj

Abstract:

This paper proposes a method to collect homeless data using crowdsourcing and presents an approach to analyze the data, demonstrating its potential to strengthen existing and future policies aimed at promoting socio-economic equilibrium. This paper's contributions can be categorized into three main areas. Firstly, a unique method for collecting homeless data is introduced, utilizing a user-friendly smartphone app (currently available for Android). The app enables the general public to quickly record information about homeless individuals, including the number of people and details about their living conditions. The collected data, including date, time, and location, is anonymized and securely transmitted to the cloud. It is anticipated that an increasing number of users motivated to contribute to society will adopt the app, thus expanding the data collection efforts. Duplicate data is addressed through simple classification methods, and historical data is utilized to fill in missing information. The second contribution of this paper is the description of data analysis techniques applied to the collected data. By combining this new data with existing information, statistical regression analysis is employed to gain insights into various aspects, such as distinguishing between unsheltered and sheltered homeless populations, as well as examining their correlation with factors like unemployment rates, housing affordability, and labor demand. Initial data is collected in San Francisco, while pre-existing information is drawn from three cities: San Francisco, New York City, and Washington D.C., facilitating the conduction of simulations. The third contribution focuses on demonstrating the practical implications of the data processing results. The challenges faced by key stakeholders, including charitable organizations and local city governments, are taken into consideration. Two case studies are presented as examples. The first case study explores improving the efficiency of food and necessities distribution, as well as medical assistance, driven by charitable organizations. The second case study examines the correlation between micro-geographic budget expenditure by local city governments and homeless information to justify budget allocation and expenditures. The ultimate objective of this endeavor is to enable the continuous enhancement of the quality of life for the underprivileged. It is hoped that through increased crowdsourcing of data from the public, the Generosity Curve and the Need Curve will intersect, leading to a better world for all.

Keywords: crowdsourcing, homelessness, socio-economic policies, statistical analysis

Procedia PDF Downloads 44

Authors: Arvind Salem

Abstract:

Voters across the country are transferring the power of redistricting from the state legislatures to commissions to secure “fairer” districts by curbing the influence of gerrymandering on redistricting. Gerrymandering, intentionally drawing distorted districts to achieve political advantage, has become extremely prevalent, generating widespread voter dissatisfaction and resulting in states adopting commissions for redistricting. However, the efficacy of these commissions is dubious, with some arguing that they constitute a panacea for gerrymandering, while others contend that commissions have relatively little effect on gerrymandering. A result showing that commissions are effective would allay these fears, supplying ammunition for activists across the country to advocate for commissions in their state and reducing the influence of gerrymandering across the nation. However, a result against commissions may reaffirm doubts about commissions and pressure lawmakers to make improvements to commissions or even abandon the commission system entirely. Additionally, these commissions are publicly funded: so voters have a financial interest and responsibility to know if these commissions are effective. Currently, nine states place commissions in charge of redistricting, Arizona, California, Colorado, Michigan, Idaho, Montana, Washington, and New Jersey (Hawaii also has a commission but will be excluded for reasons mentioned later). This study compares the degree of gerrymandering in the 2022 election (“after”) to the election in which voters decided to adopt commissions (“before”). The before-election provides a valuable benchmark for assessing the efficacy of commissions since voters in those elections clearly found the districts to be unfair; therefore, comparing the current election to that one is a good way to determine if commissions have improved the situation. At the time Hawaii adopted commissions, it was merely a single at-large district, so it is before metrics could not be calculated, and it was excluded. This study will use three methods to quantify the degree of gerrymandering: the efficiency gap, the percentage of seats and the percentage of votes difference, and the mean-median difference. Each of these metrics has unique advantages and disadvantages, but together, they form a balanced approach to quantifying gerrymandering. The study uses a Wilcoxon Signed-Rank Test with a null hypothesis that the value of the metrics is greater than or equal to after the election than before and an alternative hypothesis that the value of these metrics is greater in the before the election than after using a 0.05 significance level and an expected difference of 0. Accepting the alternative hypothesis would constitute evidence that commissions reduce gerrymandering to a statistically significant degree. However, this study could not conclude that commissions are effective. The p values obtained for all three metrics (p=0.42 for the efficiency gap, p=0.94 for the percentage of seats and percentage of votes difference, and p=0.47 for the mean-median difference) were extremely high and far from the necessary value needed to conclude that commissions are effective. These results halt optimism about commissions and should spur serious discussion about the effectiveness of these commissions and ways to change them moving forward so that they can accomplish their goal of generating fairer districts.

Keywords: commissions, elections, gerrymandering, redistricting

Procedia PDF Downloads 73

Authors: Maggie Hall, Haley O'Neill

Abstract:

The U.S. faces a severe shortage of abortion providers, exacerbated by the June 2022 Dobbs v. Jackson Women’s Health Organization decision. Midwives, especially certified nurse midwives, are well-positioned to fill this gap in abortion care. However, a lack of clinical education and training prevents midwives from exercising their full scope of practice. National and international organizations that set obstetrics and midwifery education standards, including the International Confederation of Midwives, American College of Obstetricians and Gynecologists, and American Public Health Association, call for expansion of midwifery-managed abortion care through the first trimester. In the U.S., midwifery programs are accredited based on compliance with ACME standards and compliance is a prerequisite for the American Midwifery Certification Board exams. We conducted a literature review of studies in the last five years regarding abortion didactic and clinical education barriers via CINAHL, EBSCO and PubMed database reviews. We gave preference for primary sources within the last five years; however, due to the rapid changes in abortion education and access, we also included literature from 2012-2022. We evaluated ACME-accredited programs in relation to their geography within abortion-protected or restricted states and assessed state-specific barriers to abortion care education and provision as clinical students. There are 43 AMCB-accredited midwifery schools in 28 states across the U.S. Twenty schools (47%) are in the 15 states in which advanced practice clinicians can provide non-surgical abortion care, such as medication abortion and MVA procedures. Twenty-four schools (56%) are in the 16 states in which abortion care provision is restricted to Licensed Physicians and cannot offer in-state clinical training opportunities for midwifery students. Six schools are in the five states in which abortion is completely banned and are geographically concentrated in the southernmost region of the U.S., including Alabama, Kentucky, Louisiana, Tennessee, and Texas. Subsequently, these programs cannot offer in-state clinical training opportunities for midwifery students. Notably, there are seven ACME programs in six states that do not restrict abortion access by gestational age, including Colorado, Connecticut, Washington, D.C., New Jersey, New Mexico, and Oregon. These programs may be uniquely positioned for midwifery involvement in abortion care beyond the first trimester. While the following states don’t house ACME programs, abortion care can be provided by advanced practice clinicians in Rhode Island, Delaware, Hawaii, Maine, Maryland, Montana, New Hampshire, and Vermont, offering clinical placement and/or new ACME program development opportunities. We identify existing barriers to clinical education and training opportunities for midwifery-managed abortion care, which are both geographic and institutional in nature. We recommend expansion and standardization of clinical education and training opportunities for midwifery-managed abortion care in ACME-accredited programs to improve access to abortion care. Midwifery programs and teaching hospitals need to expand education, training, and residency opportunities for midwifery students to strengthen access to midwife-managed abortion care. ACNM and ACME should re-evaluate accreditation criteria and the implications of ACME programs in states where students are not able to learn abortion care in clinical contexts due to state-specific abortion restrictions.

Keywords: midwifery education, abortion, abortion education, abortion access

Procedia PDF Downloads 81

Authors: Ashleigh Dawn Moeller

Abstract:

This is a comparative case study which examines the language attitudes and behaviors of descendants of Volga German immigrants in North America and how these attitudes combined with surrounding social conditions have caused their heritage language to develop differently within each community. Of particular interest for this study are the accounts of second- and third-generation descendants in Oregon, Kansas, and North Dakota regarding their parents’ and grandparents’ attitudes toward their language and how this correlates with the current sentiment as well as visibility of their heritage language and culture. This study discusses the point at which cultural identity could diverge from language identity and what elements play a role in this development, establishing the potential for environments (linguistic landscapes) which uphold their heritage yet have detached from the language itself. Emigrating from Germany in the 1700s, these families settled for over a hundred years along the Volga Region of Imperial Russia. Subsequently, many descendants of these settlers immigrated to the Americas in the 1800-1900s. Identifying neither as German nor Russian, they called themselves Wolgadeutche (Volga Germans). During their time in Russia, the German language was maintained relatively homogenously, yet the use and status of their heritage language diverged considerably upon settlement across the Americas. Data shows that specific conditions, such as community isolation, size, religion, location as well as language policy established prior to and following the Volga German immigration to North America have had a substantial impact on the maintenance of their heritage language—causing complete loss in some areas and peripheral use or even full rebirth in others. These past conditions combined with the family accounts correlate directly with the general attitudes and ideologies of the descendants toward their heritage language. Data also shows that in many locations, despite a strong presence of German within the linguistic landscape, minimal to no German is spoken nor understood; the attitude toward the language is indifferent while a staunch holding to the heritage is maintained and boasted. Data for this study was gathered from historical accounts, archived records and newspapers, and published biographies as well as from formal interviews with second- and third-generation descendants of Volga German immigrants conducted in Oregon and Kansas. Through the interviews, members of the community have shared and provided their family genealogies as well as biographies published by family members. These have helped to trace their relatives back to specific locations, thus allowing for comparisons within the same families residing in distinctly different areas of North America. This study is part of a larger ongoing project which researches the immigration of Volga and Black Sea Germans to North America and diachronically examines the over-arching sociological factors which have directly impacted the maintenance, loss, or rebirth of their heritage language. This project follows specific families who settled in areas of Colorado, Kansas, Nebraska, Illinois, Minnesota, North and South Dakota, Saskatchewan, and Manitoba, and who later had relatives move west to areas of Oregon and Washington State. Interviews for the larger project will continue into the following year.

Keywords: heritage language, immigrant language, language change, language contact, linguistic landscape, Volga Germans, Wolgadeutsche

Procedia PDF Downloads 121

Authors: Anudeep Appe, Bhanu Poluparthi, Lakshmi Kasivajjula, Udai Mv, Sobha Bagadi, Punya Modi, Aditya Singh, Hemanth Gunupudi, Spenser Troiano, Jeff Paul, Justin Stovall, Justin Yamamoto

Abstract:

The necessity of data-driven decisions in healthcare strategy formulation is rapidly increasing. A reliable framework which helps identify factors impacting a healthcare provider facility or a hospital (from here on termed as facility) market share is of key importance. This pilot study aims at developing a data-driven machine learning-regression framework which aids strategists in formulating key decisions to improve the facility’s market share which in turn impacts in improving the quality of healthcare services. The US (United States) healthcare business is chosen for the study, and the data spanning 60 key facilities in Washington State and about 3 years of historical data is considered. In the current analysis, market share is termed as the ratio of the facility’s encounters to the total encounters among the group of potential competitor facilities. The current study proposes a two-pronged approach of competitor identification and regression approach to evaluate and predict market share, respectively. Leveraged model agnostic technique, SHAP, to quantify the relative importance of features impacting the market share. Typical techniques in literature to quantify the degree of competitiveness among facilities use an empirical method to calculate a competitive factor to interpret the severity of competition. The proposed method identifies a pool of competitors, develops Directed Acyclic Graphs (DAGs) and feature level word vectors, and evaluates the key connected components at the facility level. This technique is robust since its data-driven, which minimizes the bias from empirical techniques. The DAGs factor in partial correlations at various segregations and key demographics of facilities along with a placeholder to factor in various business rules (for ex. quantifying the patient exchanges, provider references, and sister facilities). Identified are the multiple groups of competitors among facilities. Leveraging the competitors' identified developed and fine-tuned Random Forest Regression model to predict the market share. To identify key drivers of market share at an overall level, permutation feature importance of the attributes was calculated. For relative quantification of features at a facility level, incorporated SHAP (SHapley Additive exPlanations), a model agnostic explainer. This helped to identify and rank the attributes at each facility which impacts the market share. This approach proposes an amalgamation of the two popular and efficient modeling practices, viz., machine learning with graphs and tree-based regression techniques to reduce the bias. With these, we helped to drive strategic business decisions.

Keywords: competition, DAGs, facility, healthcare, machine learning, market share, random forest, SHAP

Procedia PDF Downloads 91

Authors: N. Rambabu, H. Gururaj, Reynold Washington, Oommen George

Abstract:

Motivation: Under the USAID Strengthening Health Outcomes through Private Sector (SHOPS-TB) initiative, Karnataka Health Promotion Trust (KHPT) with technical support of Abt associates is implementing a TB prevention and care model in Karnataka State, South India. KHPT is the interface agency between the public and private sectors, and providers and the target community facilitating early TB case detection and enhancing treatment compliance through private health care providers (pHCP) engagement in RNTCP. The project coverage is 0.84 million urban poor from 663 slums in 12 districts of Karnataka. Problem Statement: India with the highest burden of global TB (26%) and two million cases annually, accounts for approximately one fifth of the global incidence. WHO estimates 300,000 people die from TB annually in India. India expanded the coverage of Directly Observed Treatment, Short-course chemotherapy (DOTS) to the entire country as early as 2006. However, the performance of RNTCP has not been uniform across states. While the national annual new smear-positive (NSP) case notification rate is 53, it is much lower at 47 in Karnataka. A third of TB patients in India reside in urban slums. Approach: Under SHOPS, KHPT actively engages with communities through key opinion leaders and community structures. Interpersonal communication, by Outreach workers through house-to-house visits and at aggregation points, is the primary method used for communication about TB and its management and to increase demand for sputum examination and DOTS. pHCP are mapped, trained and mentored by KHPT. ORWs also provide patient and family counseling on TB treatment, side effects and adherence, screen close contacts of index patients especially children under 6 years of age and screen co-morbidities including HIV, diabetes and malnutrition and risk factors including alcoholism, tobacco use, occupational hazards making appropriate accompanied or documented referrals. A treatment ‘buddy’ system for the patients involving close friends or family members, ICT-based support, DOTS Prerana (inspiration) groups of TB patients, family members and community, DOTS Mitra (friend) helpline services are also used for care and support services. Results: The intervention educated 39988 slum dwellers, referred 1731 chest symptomatics, tested 1061 patients and initiated 248 patients on anti-TB treatment within three months of intervention through continuous community engagement. Conclusions: The intervention’s potential to increase access to preferred health care providers, reduce patient and health system delays in diagnosis and initiation of treatment, improve health seeking behaviour and enhance compliance of pHCPs to standard treatment protocols is being monitored. Initial results are promising.

Keywords: DOTS, KHPT, health outcomes, public and private sector

Procedia PDF Downloads 316

Authors: Bryana Woodard, Monica Mitchell, Kasey Harry, Ebony Washington, Megan Harris, Marcia Boyd, Regina Lynch, Daphene Baines, Surbi Bankar

Abstract:

Introduction: African Americans experience mental health illnesses (i.e., depression, anxiety, etc.) at higher rates than their white counterparts. Despite this, they utilize mental health resources less and have lower mental health literacy, perhaps due to cultural barriers- including but not limited to mistrust. Research acknowledges African Americans’ close ties to community networks, identifying these linkages as key to establishing comfort and trust. Similarly, the church has historically been a space that creates unity and community among African Americans. Studies show that longstanding academic-community partnerships with organizations, such as churches and faith-based entities, have the capability to effectively address health and mental health barriers and needs in African Americans. The importance of implementing faith-based approaches is supported in the literature, however few empirical studies exist. This project describes the First Ladies for Health and Cincinnati Children's Hospital Medical Center (CCHMC) Partnership (FLFH-CCHMC Partnership) and the implementation and assessment of an annual Mental Health Symposium, the overall aim of which was to increase mental health awareness and decrease stigma in African American communities. Methods: The specific goals of the FLFH Mental Health Symposium were to (1) Collaborate with trusted partners to build trust with community participants; (2) Increase mental health literacy and decrease mental health stigma; (3) Understand the barriers to improving mental health and improving trust; (4) Assess the short-term outcomes two months following the symposium. Data were collected through post-event and follow-up surveys using a mixed methods approach. Results: More than 100 participants attended each year with over 350 total participants over three years. 98.7% of participants were African American, 86.67% female, 11.6% male, and 11.6% LGBTQ+/non-binary; 10.5% of participants were teens, with the remainder aged 20 to 80 plus. The event was successful in achieving its goals: (1a) Eleven different speakers from 8 community and church organizations presented; (1b) 93% of participants rated the overall symposium as very good or excellent (2a) Mental health literacy significantly increased each year with over 90% of participants reporting improvement in their “understanding” and “awareness of mental health (2b) Participants 'personal stigma surrounding mental health illness decreased each year with 92.3% of participants reporting changes in their “willingness to talk about and share” mental health challenges; (3) Barriers to mental health care were identified and included social stigma, lack of trust, and the cost of care. Data were used to develop priorities and an action plan for the FLFH-CCHMC Mental Health Partnership; (4) Follow-up data showed that participants sustained benefits of the FLFH Symposium and took actionable steps (e.g., meditation, referrals, etc.). Additional quantitative and qualitative data will be shared. Conclusions: Lower rates of mental health literacy and higher rates of stigma among participants in this initiative demonstrate the importance of mental health providers building trust and partnerships in communities. Working with faith-based entities provides an opportunity to mitigate and address mental health equity in African American communities.

Keywords: community psychology, faith-based, african-american, culturally competent care, mental health equity

Procedia PDF Downloads 34