Search results for: safe motherhood program India
1796 Assessment of Vehicular Accidents and Possible Mitigation Measures: A Case of Ahmedabad, Gujarat, India
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Rapid urbanization is one of the consequences of rapid population explosion, which has also led to massive increase in number of motorized vehicles essential for carrying out all activities needed for sustaining urban livelihood. With this increased use of motorized vehicles over the time there has also been an increase in number of accidents. Study of road network and geometric features are essential to tackle problems of road accidents in any district or town. The increase in road accidents is one of the burning issues in the present society. Records show that there is one death at every 3.7 minutes because of road accident. It has been found from the research that, accidents occur due to, mistakes of the driver (86%) followed by bad street condition (5%), mistake of pedestrian (4%), as well as technical and maintenance defects (1%). Here, case study of Ahmedabad, Gujarat is taken up where first road safety level is assessed considering various parameters. The study confined to accident characteristics of all types of vehicles. For deeper analysis, road safety index for various stretches in Ahmedabad was found out. Crash rate for same stretches was found out. Based on various parameters priority was decided so that which stretch should be look out first to minimize road accidents on that stretch and which stretch should look out last. The major findings of the study are that accident severity of Ahmedabad has increased, but accident fatality risk has decreased; thus there is need to undertake some traffic engineering measures or make some traffic rules that are strictly followed by traffic. From the above study and literature studied it is found that Ahmedabad is suffering from similar problem of accidents and injuries and deaths caused by them, after properly investigating the issue short-term and long-term solutions to minimize road accidents have been presented in this paper.Keywords: accident severity index, accident fatality rate, accident fatality risk, accident risk, road safety index
Procedia PDF Downloads 1421795 Teachers’ Perceptions Related to the Guiding Skills within the Application Courses
Authors: Tanimola Kazeem Abiodun
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In Nigeria, both formal education and distance learning opportunities are used in teacher training. Practical courses aim to improve the skills of teacher candidates in a school environment. Teacher candidates attend kindergarten classes under the supervision of a teacher. In this context, the guiding skills of teachers gain importance in terms of shaping candidates’ perceptions about teaching profession. In this study, the teachers’ perceptions related to the guiding skills within the practical courses were determined. Also, the perceptions and applications related to guiding skills were compared. A Likert scale questionnaire and an open-ended question were used to determine perceptions and applications. 120 questionnaires were taken into consideration and analyses of data were performed by using percentage distribution and QSR Nvivo 8 program. In this study, statements related to teachers’ perceptions about the guiding skills were asked and it is determined that almost all the teachers agreed about the importance of these statements. On the other hand, how these guidance skills are applied by teachers is also queried with an open-ended question. Finally, thoughts and applications related to guidance skills were compared to each other. Based on this comparison, it is seen that there are some differences between the thoughts and applications especially related with time management, planning, feedbacks, curriculum, workload, rules and guidance. It can be said that some guidance skills cannot be controlled only by teachers. For example, candidates’ motivation, attention, population and educational environment are also determinative factors for effective guidance. In summary, it is necessary to have prior conditions for teachers to apply these idealized guidance skills for training more successful candidates to pre-school education era. At this point, organization of practical courses by the faculties gains importance and in this context it is crucial for faculties to revise their applications based on more detailed researches.Keywords: teacher training, guiding skills, education, practical courses
Procedia PDF Downloads 4471794 Exploring the Underlying Factors of Student Dropout in Makawanpur Multiple Campus: A Comprehensive Analysis
Authors: Uttam Aryal, Shekhar Thapaliya
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This research paper presents a comprehensive analysis of the factors contributing to student dropout at Makawanpur Multiple Campus, utilizing primary data collected directly from dropped out as well as regular students and academic staff. Employing a mixed-method approach, combining qualitative and quantitative methods, this study examines into the complicated issue of student dropout. Data collection methods included surveys, interviews, and a thorough examination of academic records covering multiple academic years. The study focused on students who left their programs prematurely, as well as current students and academic staff, providing a well-rounded perspective on the issue. The analysis reveals a shaded understanding of the factors influencing student dropout, encompassing both academic and non-academic dimensions. These factors include academic challenges, personal choices, socioeconomic barriers, peer influences, and institutional-related issues. Importantly, the study highlights the most influential factors for dropout, such as the pursuit of education abroad, financial restrictions, and employment opportunities, shedding light on the complex web of circumstances that lead students to discontinue their education. The insights derived from this study offer actionable recommendations for campus administrators, policymakers, and educators to develop targeted interventions aimed at reducing dropout rates and improving student retention. The study underscores the importance of addressing the diverse needs and challenges faced by students, with the ultimate goal of fostering a supportive academic environment that encourages student success and program completion.Keywords: drop out, students, factors, opportunities, challenges
Procedia PDF Downloads 641793 A Case Study Using Sounds Write and The Writing Revolution to Support Students with Literacy Difficulties
Authors: Emilie Zimet
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During our department meetings for teachers of children with learning disabilities and difficulties, we often discuss the best practices for supporting students who come to school with literacy difficulties. After completing Sounds Write and Writing Revolution courses, it seems there is a possibility to link approaches and still maintain fidelity to a program and provide individualised instruction to support students with such difficulties and disabilities. In this case study, the researcher has been focussing on how best to use the knowledge acquired to provide quality intervention that targets the varied areas of challenge that students require support in. Students present to school with a variety of co-occurring reading and writing deficits and with complementary approaches, such as The Writing Revolution and Sounds Write, it is possible to support students to improve their fundamental skills in these key areas. Over the next twelve weeks, the researcher will collect data on current students with whom this approach will be trialled and then compare growth with students from last year who received support using Sounds-Write only. Maintaining fidelity may be a potential challenge as each approach has been tested in a specific format for best results. The aim of this study is to determine if approaches can be combined, so the implementation will need to incorporate elements of both reading (from Sounds Write) and writing (from The Writing Revolution). A further challenge is the time length of each session (25 minutes), so the researcher will need to be creative in the use of time to ensure both writing and reading are targeted while ensuring the programs are implemented. The implementation will be documented using student work samples and planning documents. This work will include a display of findings using student learning samples to demonstrate the importance of co-targeting the reading and writing challenges students come to school with.Keywords: literacy difficulties, intervention, individual differences, methods of provision
Procedia PDF Downloads 541792 Unveiling Microbial Potential: Investigating Zinc-Solubilizing Fungi in Rhizospheric Soil Through Isolation, Characterization and Selection
Authors: Pukhrambam Helena Chanu, Janardan Yadav
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This study investigates the potential of various fungal isolates to solubilize zinc and counteract rice pathogens, with the aim of mitigating zinc deficiency and disease prevalence in rice farming. Soil samples from the rhizosphere were collected, and zinc-solubilizing fungi were isolated and purified. Molecular analysis identified Talaromyces sp, Talaromyces versatilis, Talaromyces pinophilus, and Aspergillus terreus as effective zinc solubilizers. Through qualitative and quantitative assessments, it was observed that solubilization efficiencies varied among the isolates over time, with Talaromyces versatilis displaying the highest capacity for solubilization. This variability in solubilization rates may be attributed to differences in fungal metabolic activity and their ability to produce organic acids that facilitate zinc release from insoluble sources in the soil. In inhibition assays against rice pathogens, the fungal isolates exhibited antagonistic properties, with Talaromyces versatilis demonstrating the most significant inhibition rates. This antagonistic activity may be linked to the production of secondary metabolites, such as antibiotics or lytic enzymes by fungi, which inhibit the growth of rice pathogens. The ability of Talaromyces versatilis to outperform other isolates in both zinc solubilization and pathogen inhibition highlights its potential as a multifunctional biocontrol agent in rice cultivation systems. These findings emphasize the potential of fungi as natural solutions for enhancing zinc uptake and managing diseases in rice cultivation. Utilizing indigenous zinc-solubilizing fungi offers a sustainable and environmentally friendly approach to addressing zinc deficiency in soils, reducing the need for chemical fertilizers. Moreover, harnessing the antagonistic activity of these fungi can contribute to integrated disease management strategies, minimizing reliance on synthetic pesticides and promoting ecological balance in agroecosystems. Additionally, the study included the evaluation of dipping time under different concentrations, viz.,10 ppm, 20 ppm, and 30 ppm of biosynthesized nano ZnO on rice seedlings. This investigation aimed to optimize the application of nano ZnO for efficient zinc uptake by rice plants while minimizing potential risks associated with excessive nanoparticle exposure. Evaluating the effects of varying concentrations and dipping durations provides valuable insights into the safe and effective utilization of nano ZnO as a micronutrient supplement in rice farming practices.Keywords: biosynthesized nano ZnO, rice, root dipping, zinc solubilizing fungi.
Procedia PDF Downloads 491791 Validity and Reliability of a Questionaire for Measuring Behaviour Change of Low Performance Employee
Authors: Hazaila Binti Hassan, Abu Yazid Bin Abu Bakar, Salleh Amat
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This study is to get the validity and reliability of the questionnaire for behaviour change on low-performing officers. This study aimed to develop and evaluate the behaviour of low performing officers. There are 75 items in this questionnaire which involves 5 subscales, which are the 5 dimensions intended to be studied: 1st emotional stability, 2nd psycho-spiritual enhancement, 3rd social skills development, 4th cognitive and rationality improvement and 5th behavioural alignment and adjustment. There are 2 processes in this research whereby to check the validity and reliability. Both use quantitative methods. Validity content testing has been conducted to validate the behavioural change questionnaire of the low performing officers. For the face validity, 4 people are involved, two are psychologists who carried out the program and the other two are officers of the same rank, i.e. supporting officers. They are involved in correction of sentences, languages, and grammar as well as the sentence structures so that it tallies with the purpose of studies. The questionnaire underwent content validity by the experts. Five experts are appointed to attend this session, 3 are directly involved in the construction of this questionnaire and 2 others are experts from the university with a background in questionnaire development. The result shows that the content validity obtained a high coefficient of 0.745 with a minimum and maximum value of more than 0.60 which satisfies the characteristic of Content Value Ratio. The Cronbach’s alpha result is 0.867. The highest scores are the behavioural alignment and adjustment sub-scale recorded the highest value, followed by social skills development sub-scale, cognitive and rational improvements sub-scale, psycho-spiritual enhancement sub-scale, and lastly emotional stability. Therefore, both of validity and reliability result were accepted that this questionnaire is valid and reliable can be used in the study of behaviour changes of low performing officers in the civil service.Keywords: content validity, reliability, five dimension, low-performing officers, questionnaire
Procedia PDF Downloads 2831790 Effects of Occupational Therapy on Children with Unilateral Cerebral Palsy
Authors: Sedef Şahin, Meral Huri
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Cerebral Palsy (CP) represents the most frequent cause of physical disability in children with a rate of 2,9 per 1000 live births. The activity-focused intervention is known to improve function and reduce activity limitations and barriers to participation of children with disabilities. The aim of the study was to assess the effects of occupational therapy on level of fatigue, activity performance and satisfaction in children with Unilateral Cerebral Palsy. Twenty-two children with hemiparetic cerebral palsy (mean age: 9,3 ± 2.1years; Gross Motor Function Classification System ( GMFCS) level from I to V (I = 54%, II = 23%, III = 14%, IV= 9%, V= 0%), Manual Ability Classification System (MACS) level from I to V (I = 40%, II = 32%, III = 14%, IV= 10%, V= 4%), were assigned to occupational therapy program for 6 weeks.Visual Analogue Scale (VAS) was used for intensity of the fatigue they experienced at the time on a 10 point Likert scale (1-10).Activity performance and satisfaction were measured with Canadian Occupational Performance Measure (COPM).A client-centered occupational therapy intervention was designed according to results of COPM. The results were compared with nonparametric Wilcoxon test before and after the intervention. Thirteen of the children were right-handed, whereas nine of the children were left handed.Six weeks of intervention showed statistically significant differences in level of fatigue, compared to first assessment(p<0,05). The mean score of first and the second activity performance scores were 4.51 ± 1.70 and 7.35 ± 2.51 respectively. Statistically significant difference between performance scores were found (p<0.01). The mean scores of first and second activity satisfaction scores were of 2.30± 1.05 and 5.51 ± 2.26 respectively. Statistically significant difference between satisfaction assessments were found (p<0.01). Occupational therapy is an evidence-based approach and occupational therapy interventions implemented by therapists were clinically effective on severity of fatigue, activity performance and satisfaction if implemented individually during 6 weeks.Keywords: activity performance, cerebral palsy, fatigue, occupational therapy
Procedia PDF Downloads 2371789 Priority Analysis for Korean Disaster Mental Health Service Model Using Analytic Hierarchy Process
Authors: Myung-Soo Lee, Sun-Jin Jo, Kyoung-Sae Na, Joo-Eon Park
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Early intervention after a disaster is important for recovery of disaster victims and each country has its own professional mental health service system such as Disaster Psychiatric Assistant Team in Japan and Crisis Counseling Program in the USA. The purpose of this study was to determine key prior components of the Korean Disaster Psychiatric Assistant Team (K-DPAT) for building up Korean disaster mental health service system. We conducted an Analytic Hierarchy Process(AHP) with disaster mental health experts using pairwise comparison questionnaire which compares the relative importance of the key components of Korean disaster mental health service system. Forty-one experts answered the first online survey, and among them, 36 responded to the second. Ten experts were participated in panel meeting and discussed the results of the survey and AHP process. Participants decided the relative importance of the Korean disaster mental health service system regarding initial professional intervention as follows. K-DPAT could be organized at a national level (43.0%) or regional level (40.0%). K-DPAT members should be managed (59.0%) and educated (52.1%) by national level than regional or local level. K-DPAT should be organized independent of the preexisting mental health system (70.1%). Funding for K-DPAT should be from the Ministry of Public Safety and the system could be managed by Ministry of Health (65.8%). Experts agreed K-DPAT leader is suitable for key decision maker for most types of disaster except infectious disease. We expect new model for disaster mental health services can improve insufficiency of the system such as fragmentation and decrease the unmet needs of early professional intervention for the disaster victims.Keywords: analytic hierarchy process, decision making, disaster, DPAT, mental health services
Procedia PDF Downloads 2761788 Investigation into the Suitability of Aggregates for Use in Superpave Design Method
Authors: Ahmad Idris, Armaya`u Suleiman Labo, Ado Yusuf Abdulfatah, Murtala Umar
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Super pave is the short form of Superior Performing Asphalt Pavement and represents a basis for specifying component materials, asphalt mixture design and analysis, and pavement performance prediction. This new technology is the result of long research projects conducted by the strategic Highway Research program (SHRP) of the Federal Highway Administration. This research was aimed at examining the suitability of Aggregates found in Kano for used in super pave design method. Aggregates samples were collected from different sources in Kano Nigeria and their Engineering properties, as they relate to the SUPERPAVE design requirements were determined. The average result of Coarse Aggregate Angularity in Kano was found to be 87% and 86% of one fractured face and two or more fractured faces respectively with a standard of 80% and 85% respectively. Fine Aggregate Angularity average result was found to be 47% with a requirement of 45% minimum. A flat and elongated particle which was found to be 10% has a maximum criterion of 10%. Sand equivalent was found to be 51% with the criteria of 45% minimum. Strength tests were also carried out, and the results reflect the requirements of the standards. The tests include Impact value test, Aggregate crushing value and Aggregate Abrasion tests and the results are 27.5%, 26.7% and 13% respectively with a maximum criteria of 30%. Specific gravity was also carried out and the result was found to have an average value of 2.52 with a criterion of 2.6 to 2.9 and Water absorption was found to be 1.41% with maximum criteria of 0.6%. From the study, the result of the tests indicated that the aggregates properties have met the requirements of Super pave design method based on the specifications of ASTMD 5821, ASTM D 4791, AASHTO T176, AASHTO T33 and BS815.Keywords: aggregates, construction, road design, super pave
Procedia PDF Downloads 2381787 Using the Transtheoretical Model to Investigate Stages of Change in Regular Volunteer Service among Seniors in Community
Authors: Pei-Ti Hsu, I-Ju Chen, Jeu-Jung Chen, Cheng-Fen Chang, Shiu-Yan Yang
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Taiwan now is an aging society Research on the elderly should not be confined to caring for seniors, but should also be focused on ways to improve health and the quality of life. Senior citizens who participate in volunteer services could become less lonely, have new growth opportunities, and regain a sense of accomplishment. Thus, the question of how to get the elderly to participate in volunteer service is worth exploring. Apply the Transtheoretical Model to understand stages of change in regular volunteer service and voluntary service behaviour among the seniors. 1525 adults over the age of 65 from the Renai district of Keelung City were interviewed. The research tool was a self-constructed questionnaire and individual interviews were conducted to collect data. Then the data was processed and analyzed using the IBM SPSS Statistics 20 (Windows version) statistical software program. In the past six months, research subjects averaged 9.92 days of volunteer services. A majority of these elderly individuals had no intention to change their regular volunteer services. We discovered that during the maintenance stage, the self-efficacy for volunteer services was higher than during all other stages, but self-perceived barriers were less during the preparation stage and action stage. Self-perceived benefits were found to have an important predictive power for those with regular volunteer service behaviors in the previous stage, and self-efficacy was found to have an important predictive power for those with regular volunteer service behaviors in later stages. The research results support the conclusion that community nursing staff should group elders based on their regular volunteer services change stages and design appropriate behavioral change strategies.Keywords: seniors, stages of change in regular volunteer services, volunteer service behavior, self-efficacy, self-perceived benefits
Procedia PDF Downloads 4261786 Voice of Customer: Mining Customers' Reviews on On-Line Car Community
Authors: Kim Dongwon, Yu Songjin
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This study identifies the business value of VOC (Voice of Customer) on the business. Precisely, we intend to demonstrate how much negative and positive sentiment of VOC has an influence on car sales market share in the unites states. We extract 7 emotions such as sadness, shame, anger, fear, frustration, delight and satisfaction from the VOC data, 23,204 pieces of opinions, that had been posted on car-related on-line community from 2007 to 2009(a part of data collection from 2007 to 2015), and intend to clarify the correlation between negative and positive sentimental keywords and contribution to market share. In order to develop a lexicon for each category of negative and positive sentiment, we took advantage of Corpus program, Antconc 3.4.1.w and on-line sentimental data, SentiWordNet and identified the part of speech(POS) information of words in the customers' opinion by using a part-of-speech tagging function provided by TextAnalysisOnline. For the purpose of this present study, a total of 45,741 pieces of customers' opinions of 28 car manufacturing companies had been collected including titles and status information. We conducted an experiment to examine whether the inclusion, frequency and intensity of terms with negative and positive emotions in each category affect the adoption of customer opinions for vehicle organizations' market share. In the experiment, we statistically verified that there is correlation between customer ideas containing negative and positive emotions and variation of marker share. Particularly, "Anger," a domain of negative domains, is significantly influential to car sales market share. The domain "Delight" and "Satisfaction" increased in proportion to growth of market share.Keywords: data mining, opinion mining, sentiment analysis, VOC
Procedia PDF Downloads 2141785 Microbial Electrochemical Remediation System: Integrating Wastewater Treatment with Simultaneous Power Generation
Authors: Monika Sogani, Zainab Syed, Adrian C. Fisher
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Pollution of estrogenic compounds has caught the attention of researchers as the slight increase of estrogens in the water bodies has a significant impact on the aquatic system. They belong to a class of endocrine disrupting compounds (EDCs) and are able to mimic hormones or interfere with the action of endogenous hormones. The microbial electrochemical remediation system (MERS) is employed here for exploiting an electrophototrophic bacterium for evaluating the capacity of biodegradation of ethinylestradiol hormone (EE2) under anaerobic conditions with power generation. MERS using electro-phototrophic bacterium offers a tailored solution of wastewater treatment in a developing country like India which has a huge solar potential. It is a clean energy generating technology as they require only sunlight, water, nutrients, and carbon dioxide to operate. Its main feature that makes it superior over other technologies is that the main fuel for this MERS is sunlight which is indefinitely present. When grown in light with organic compounds, these photosynthetic bacteria generate ATP by cyclic photophosphorylation and use carbon compounds to make cell biomass (photoheterotrophic growth). These cells showed EE2 degradation and were able to generate hydrogen as part of the process of nitrogen fixation. The two designs of MERS were studied, and a maximum of 88.45% decrease in EE2 was seen in a total period of 14 days in the better design. This research provides a better insight into microbial electricity generation and self-sustaining wastewater treatment facilities. Such new models of waste treatment aiming waste to energy generation needs to be followed and implemented for building a resource efficient and sustainable economy.Keywords: endocrine disrupting compounds, ethinylestradiol, microbial electrochemical remediation systems, wastewater treatment
Procedia PDF Downloads 1181784 Exploring the Stressors Faced by Sportspersons: A Qualitative Study on Young Indian Sportspersons and Their Coping Strategies to Stress
Authors: Moyera Sanganeria
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In the highly competitive landscape of contemporary sports, sportspersons worldwide encounter formidable challenges, often practicing for extensive hours while contending with limited social and physical resources. A growing number of sportspersons globally are sharing their struggles with depression, anxiety, and stress arising from the complex journey and identity associated with being a sportsperson. This qualitative study aims to investigate the challenges faced by sportspersons in individual versus team sports and explore potential gender-based variations in coping strategies. It attempts to do so by recognizing the imperative to comprehend the root causes and coping mechanisms for these stressors. By employing purposive sampling, MMA and Kabaddi players from training academies across Mumbai were selected for the study. Twelve participants were interviewed through semi-structured interviews guided by an interview guide. Reflective thematic analysis was employed to discern diverse stressors and coping strategies. Key stressors encountered by young Indian sportspersons encompass injuries, socio-economic challenges, financial constraints, escalating competition, and performance anxiety. Notably, individuals engaged in team sports tended to adopt emotion-focused coping mechanisms, while those in individual sports leaned more towards problem-focused coping strategies in response to these stressors. There were no prominent gender differences found in coping strategies employed by sportspersons. This study underscores the critical issue of declining mental health among sportspersons in India, emphasizing the necessity for a structured and customized mental health intervention strategy tailored to the unique needs of this population.Keywords: stressors, coping strategies, sports psychology, sportspersons, mental health
Procedia PDF Downloads 801783 Software Architecture Implications on Development Productivity: A Case of Malawi Point of Care Electronic Medical Records
Authors: Emmanuel Mkambankhani, Tiwonge Manda
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Software platform architecture includes system components, their relationships, and design, as well as evolution principles. Software architecture and documentation affect a platform's customizability and openness to external innovators, thus affecting developer productivity. Malawi Point of Care (POC) Electronic Medical Records System (EMRS) follows some architectural design standards, but it lacks third-party innovators and is difficult to customize as compared to CommCare and District Health Information System 2 (DHIS2). Improving software architecture and documentation for the Malawi POC will increase productivity and third-party contributions. A conceptual framework based on Generativity and Boundary Resource Model (BRM) was used to compare the three platforms. Interviews, observations, and document analysis were used to collect primary and secondary data. Themes were found by analyzing qualitative and quantitative data, which led to the following results. Configurable, flexible, and cross-platform software platforms and the availability of interfaces (Boundary Resources) that let internal and external developers interact with the platform's core functionality, hence boosting developer productivity. Furthermore, documentation increases developer productivity, while its absence inhibits the use of resources. The study suggests that the architecture and openness of the Malawi POC EMR software platform will be improved by standardizing web application program interfaces (APIs) and making interfaces that can be changed by the user. In addition, increasing the availability of documentation and training will improve the use of boundary resources, thus improving internal and third-party development productivity.Keywords: health systems, configurable platforms, software architecture, software documentation, software development productivity
Procedia PDF Downloads 881782 Nutritional Status of Rural Women in Bengaluru Rural District of Karnataka, India
Authors: A. M. Maruthesh, B. M. Anandakumar, O. Kumara, Akshatha Gombi, S. R. Rajini
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Women play a vital role in ensuring proper development and growth of children. They also contribute significantly towards income generation, food preparation and health. Nutritional status reflects the health of a person and is influenced by the quality of foods eaten and the ability of the body to utilize these foods to meet its needs it is affected by various socio-economic factors including income, family size, occupation and educational status of the people. The study was undertaken on nutritional status of rural women in Heggadehalli of Doddaballapurtaluk and Venkathalli of Devanahallitaluk in Bengaluru rural district with the sample size of 200 respondents. The prevalence of symptoms of malnutrition in a community is in turn a reflection of dietary consumption of its members. Mean anthropometric measurement of rural women were 153.8 cm of height, 46.8 kg of weight. In comparison with the mean BMI standards, it was observed that 20 percent of women were under nourished, 64 percent of women were normal and 16 percent women were obese. In comparison with the mean waist/hip ratio with standards, it was observed that 84 percent were in normal category and 16 percent were obese. Education, land holding, income and age had significant positive association with anthropometric measurements of rural women. The deficient level of haemoglobin existed in 53 percent of rural women, low in 20 percent and only 27 percent had acceptable level. The occurrence of morbidity symptoms was higher in rural women, its illness reported among women in the study were pain in hands and legs, backache, headache, pain in abdomen, fever, weakness, cold and cough and acidity. This may be due to considerable amount of workload on women who spend 8 to 9 hours at work and after returning continue their day’s work at home also.Keywords: anthrometry, body index, hemoglobin, nutrient deficiency, rural women, nutritional status
Procedia PDF Downloads 2661781 Screening of Different Native Genotypes of Broadleaf Mustard against Different Diseases
Authors: Nisha Thapa, Ram Prasad Mainali, Prakriti Chand
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Broadleaf mustard is a commercialized leafy vegetable of Nepal. However, its utilization is hindered in terms of production and productivity due to the high intensity of insects, pests, and diseases causing great loss. The plant protection part of the crop’s disease and damage intensity has not been studied much from research perspectives in Nepal. The research aimed to evaluate broadleaf mustard genotypes for resistance against different diseases. A total of 35 native genotypes of broadleaf mustard were screened at weekly intervals by scoring the plants for ten weeks. Five different diseases, such as Rhizoctonia root rot, Alternaria blight, black rot, turnip mosaic virus disease, and white rust, were reported from the broad leaf mustard genotypes. Out of 35 genotypes, 23 genotypes were found with very high Rhizoctonia Root Rot severity, whereas 8 genotypes showed very high Alternaria blight severity. Likewise, 3 genotypes were found with high Black rot severity, and 1 genotype was found with very high Turnip mosaic virus disease incidence. Similarly, 2 genotypes were found to have very high White rust severity. Among the disease of national importance, Rhizoctonia root rot was found to be the most severe disease with the greatest loss. Broadleaf mustard genotypes like Rato Rayo, CO 1002, and CO 11007 showed average to the high level of field resistance; therefore, these genotypes should be used, conserved, and stored in a mustard improvement program as the disease resistance quality or susceptibility of these genotypes can be helpful for seed producing farmers, companies and other stakeholders through varietal improvement and developmental works that further aids in sustainable disease management of the vegetable.Keywords: genotype, disease resistance, Rhizoctonia root rot severity, varietal improvement
Procedia PDF Downloads 801780 People's Perspective on Water Commons in Trans-Boundary Water Governance: A Case Study from Nepal
Authors: Sristi Silwal
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South Asian rivers support ecosystems and sustain well-being of thousands of riparian communities. Rivers however are also sources of conflict between countries and one of the contested issues between governments of the region. Governments have signed treaties to harness some of the rivers but their provisions have not been successful in improving the quality of life of those who depend on water as common property resources. This paper will present a case of the study of the status of the water commons along the lower command areas of Koshi, Gandka and Mahakali rivers. Nepal and India have signed treaties for development and management of these rivers in 1928, 1954 and 1966. The study investigated perceptions of the local community on climate-induced disasters, provision of the treaties such as water for irrigation, participation in decision-making and specific impact of women. It looked at how the local community coped with adversities. The study showed that the common pool resources are gradually getting degraded, flood events increasing while community blame ‘other state’ and state administration for exacerbating these ills. The level of awareness about provisions of existing treatise is poor. Ongoing approach to trans-boundary water management has taken inadequate cognizance of these realities as the dominant narrative perpetuates cooperation between the governments. The paper argues that on-going discourses on trans-boundary water development and management need to use a new metrics of taking cognizance of the condition of the commons and that of the people depended on them for sustenance. In absence of such narratives, the scale of degradation would increase making those already marginalized more vulnerable to impacts of global climate change.Keywords: climate change vulnerability, conflict, cooperation, water commons
Procedia PDF Downloads 2361779 The Effect of Four-Week Resistance Exercise along with Milk Consumption on NT-proBNP and Plasma Troponin I
Authors: Rostam Abdi, Ahmad Abdi, Zahra Vahedi Langrodi
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The aim of this study is to investigate four-week resistance exercise and milk supplement on NT-proBNP and plasma troponin I of male students. Concerning the methodology of the study, 21 senior high school students of Ardebil city were selected. The selected subjects were randomly shared in three groups of control, exercise- water and exercise- milk. The exercise program includes resistance exercise for a big muscle group. The subjects of control group rested during the study and did not participate in any training. The subjects of exercise- water experimental group immediately received 400 cc water after exercise and exercise- milk group immediately received 400 cc low fat milk. Control-water groups consumed the same amount of water. 48 hours before and after the last exercise session, the blood sample of the subjects were taken for measuring the variables. NT-proBNP and Troponin I concentrations were measured by ELISA. For data analysis, one-way variance analysis test, correlated t-test and Bonferroni post hoc test were used. The significant difference of p ≤ 0.05 was accepted. Resistance training along with milk consumption leads to increase of plasma NT-proBNP, however; this increase has not reached the significant level. Furthermore, meaningful increase was observed in plasma NT–proBNP in exercise group between pretest and posttest values. Furthermore, no meaningful difference was observed between groups in terms of Troponin I after milk consumption. It seems that endurance exercises lead to change in the structure of heart muscle and is along with an increase of NT-proBNP. Furthermore, there is the possibility that milk consumption can lead to release of heart troponin I. The mechanism through which protein supplements have been put on heart troponin I is unknown and requires more research.Keywords: resistance exercise, milk, NT-proBNP, Troponin I
Procedia PDF Downloads 2621778 A Systematic Review for the Association between Active Smoking and Latent Tuberculosis Infection
Authors: Pui Hong Chung, Wing Chi Ho, Jun Li, Cyrus Leung, Ek Yeoh
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Background: Cigarette smoking is associated with poor tuberculosis (TB) outcomes in terms of progression of active TB, relapse of TB and TB-related mortality, but the association with latent tuberculosis infection (LTBI) is unclear. The systematic review conducted aimed at studying the association between active smoking and LTBI, and likelihood of dose-response relationship. Methods: Two independent reviewers searched three electronic databases comprising PudMed, Medline by EBSCOHOST, ExcerptaMedica Database (EMBASE), from inception up to 31st Dec 2015 for studies reporting data on current smoking and the LTBI with tuberculin skin test (TST) or interferon-γ release assays (IGRAs) results, comparing the odds ratios (ORs) of outcome measure of TST or IGRAs among current smokers with 95% confidence intervals (CI). Results: Seven studies were identified, including six cross-sectional studies and one longitudinal cohort study. The outcome measures from three studies were in TST, three studies in IGRAs and one for both tests. For TST, OR ranging from 1.39 to 3.40 (95% CI) with all studies shown positive association between cigarette smoking and LTBI. For IGRAs, OR ranging from 0.47 to 1.89 (95% CI) with one study shown the negative association that might be related to impaired interferon-gamma production in immunosuppressive persons. One identified study demonstrated positive dose-response relationship in TST result. Conclusions: Cigarette smoking is likely to be a risk factor of LTBI. There is the important implication for TB and tobacco control program to halt TB by empowering public health policy. Further study is also needed to provide more evidence of the dose-response model/relationship.Keywords: latent tuberculosis infection, systematic review, active smoking, model
Procedia PDF Downloads 2561777 Valorization of Lignocellulosic Wastes– Evaluation of Its Toxicity When Used in Adsorption Systems
Authors: Isabel Brás, Artur Figueirinha, Bruno Esteves, Luísa P. Cruz-Lopes
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The agriculture lignocellulosic by-products are receiving increased attention, namely in the search for filter materials that retain contaminants from water. These by-products, specifically almond and hazelnut shells are abundant in Portugal once almond and hazelnuts production is a local important activity. Hazelnut and almond shells have as main constituents lignin, cellulose and hemicelluloses, water soluble extractives and tannins. Along the adsorption of heavy metals from contaminated waters, water soluble compounds can leach from shells and have a negative impact in the environment. Usually, the chemical characterization of treated water by itself may not show environmental impact caused by the discharges when parameters obey to legal quality standards for water. Only biological systems can detect the toxic effects of the water constituents. Therefore, the evaluation of toxicity by biological tests is very important when deciding the suitability for safe water discharge or for irrigation applications. The main purpose of the present work was to assess the potential impacts of waters after been treated for heavy metal removal by hazelnut and almond shells adsorption systems, with short term acute toxicity tests. To conduct the study, water at pH 6 with 25 mg.L-1 of lead, was treated with 10 g of shell per litre of wastewater, for 24 hours. This procedure was followed for each bark. Afterwards the water was collected for toxicological assays; namely bacterial resistance, seed germination, Lemna minor L. test and plant grow. The effect in isolated bacteria strains was determined by disc diffusion method and the germination index of seed was evaluated using lettuce, with temperature and humidity germination control for 7 days. For aquatic higher organism, Lemnas were used with 4 days contact time with shell solutions, in controlled light and temperature. For terrestrial higher plants, biomass production was evaluated after 14 days of tomato germination had occurred in soil, with controlled humidity, light and temperature. Toxicity tests of water treated with shells revealed in some extent effects in the tested organisms, with the test assays showing a close behaviour as the control, leading to the conclusion that its further utilization may not be considered to create a serious risk to the environment.Keywords: lignocellulosic wastes, adsorption, acute toxicity tests, risk assessment
Procedia PDF Downloads 3661776 Case Studies of Educational Technology Integration for Global Citizenship Development among Teacher Candidates
Authors: Erik Jon Byker
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Government leaders and education policymakers have increasingly focused on ways that teachers can better prepare children for life in a global society. Such preparation includes the development of global citizenship among young people. Yet, scholars point out that many elementary school educators and teacher candidates have limited awareness of being global citizens in an interdependent world. More and more teacher preparation programs aim to integrate global citizenship in their program plans and use educational technology to help develop global citizenship. Many non-governmental organizations (NGOs), like the Asia Society and Partnership for 21st Century Skills, have led the way in creating global citizenship frameworks that prepare teachers and students with global competencies. The development of global citizenship among teachers needs to begin even before teachers sign their first contract. Global citizenship development should start when teacher candidates are being prepared to teach. Using the Critical Cosmopolitan Theory as a conceptual lens, this paper examines the integration of global citizenship curricula in teacher education programs in North Carolina and Texas in the United States of America. Using a case study methodology, the paper describes and compares the teacher candidates’ (n=136) perceptions of the global citizenship curricula delivered with the aid of educational technology. The study found that after participating in the global citizenship curricula, participants: (1) made conceptual leaps in their global citizenship definitions; (2) developed a stronger commitment for their future role as educators in developing global citizens; and (3) were more willing to take action for social justice-related issues in education. In sum, this paper discusses empirical findings related to the ways to integrate educational technology in preparing globally competent teachers.Keywords: educational technology, global education, intercultural awareness, teacher candidates
Procedia PDF Downloads 2081775 The Impact of Diesel Exhaust Particles on Tight Junction Proteins on Nose and Lung in a Mouse Model
Authors: Kim Byeong-Gon, Lee Pureun-Haneul, Hong Jisu, Jang An-Soo
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Background: Diesel exhaust particles (DEPs) lead to trigger airway hyperresponsiveness (AHR) and airway dysfunction or inflammation in respiratory systems. Whether tight junction protein changes can contribute to development or exacerbations of airway diseases remain to be clarified. Objective: The aim of this study was to observe the effect of DEP on tight junction proteins in one airway both nose and lung in a mouse model. Methods: Mice were treated with saline (Sham) and exposed to 100 μg/m³ DEPs 1 hour a day for 5 days a week for 4 weeks and 8 weeks in a closed-system chamber attached to a ultrasonic nebulizer. Airway hyperresponsiveness (AHR) was measured and bronchoalveolar lavage (BAL) fluid, nasal lavage (NAL) fluid, lung and nasal tissue was collected. The effects of DEP on tight junction proteins were estimated using western blot, immunohistochemical in lung and nasal tissue. Results: Airway hyperresponsiveness and number of inflammatory cells were higher in DEP exposure group than in control group, and were higher in 4 and 8 weeks model than in control group. The expression of tight junction proteins CLND4, -5, and -17 in both lung and nasal tissue were significantly increased in DEP exposure group than in the control group. Conclusion: These results suggesting that CLDN4, -5 and -17 may be involved in the airway both nose and lung, suggesting that air pollutants cause to disruption of epithelial and endothelial cell barriers. Acknowledgment: This research was supported by Korea Ministry of Environment (MOE) as 'The Environmental Health Action Program' (2016001360009) and Soonchunhyang University Research Fund.Keywords: diesel exhaust particles, air pollutant, tight junction, Claudin, Airway inflammation
Procedia PDF Downloads 1441774 Experimental Studies on Flexural Behaviour on Beam Using Lathe Waste in SIFCON
Authors: R. Saravanakumar, A. Siva, R. Banupriya, K. Balasubramanian
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Slurry infiltrated fibrous concrete (SIFCON) is one of the recently developed construction material that can be considered as a special type of high performance fibre reinforced concrete (HPFRC) with higher fibre content. Fibre reinforced concrete is essentially a composite material in which fibres out of waste having higher modulus of elasticity. SIFCON is a special type of high fibrous concrete and it is having a high cementious content and sand. The matrix usually consists of cement-sand slurry or fluent mortar. The construction industry is in need of finding cost effective materials for increasing the strength of concrete structures hence an endeavour has been made in the present investigations to study the influence of addition of waste material like Lathe waste from workshop at different dosages to the total weight of concrete. The waste of steel scrap material which is available from the lathe is used as a steel fibre for innovative construction industry. To get sustainable and environmental benefits, lathe scrap as recycled fibres with concrete are likely to be used. An experimental program was carried out to investigate the flexural behavior of Slurry infiltrated fibrous concrete (SIFCON) in which the fibres having an aspect ratio of 100 is used. The investigations were done using M25 mix and tests were carried out as per recommended procedures by appropriate codes. SIFCON specimens with 8%, 10% and 12% volume of fraction fibres are used in this study. Test results were presented in comparison of SIFCON with and without conventional steel reinforcement. The load carrying capacity of SIFCON specimen is higher than conventional concrete and it also reduced crack width. In the SIFCON specimen less number of cracks as compared with conventional concrete.Keywords: SIFCON, lathe waste, RCC, fibre volume, flexural behaviour
Procedia PDF Downloads 3161773 From Sympathizers to Perpetrators: Examining the Involvement of Rural Women in Bangladesh in Violent Extremism
Authors: Shantanu Majumder
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This paper attempts to explain the factors contribute in attracting and engaging rural women in Bangladesh toward political Islam that in many cases manifests itself in the form of violent extremism (VE). Bangladesh, the fourth largest Muslim majority country in the world, has been confronting the problem of VE in the name of Islam since a long. The political Islamists, explaining the events like military operations in Afghanistan and Iraq, anti-Muslim politics in neighboring India and Myanmar, Islamophobia in the West, and several other issues in their own way, have become to a vast extent successful in creating a high level of emotion, anger and a feeling of being oppressed worldwide among the ordinary Muslims masses. Half-hearted role of public intellectuals and political expediency of liberal political forces in explaining these events in a secular democratic way also facilitate the extremists to earn political dividend. VE was perceived as an all-male activism of the political Islamists’ in the past in Bangladesh. However, evidence in the recent times shows that there are sympathizers, recruiters, and perpetrators as well among the womenfolk in favor of VE-based political Islam. The first section in this paper sheds light on the way the political Islamists build rapport with and win over the heart of target women in countryside under the camouflage of preaching authentic Islam. This section also describes the role of family in involvement of women in VE. The second section discusses wide-ranging use of websites, facebook, laptop, mobile phones and several other means in the way to motivate and radicalize women. How the involvement with political Islamists brings changes in thinking process, lifestyle and family life of motivated women has been focused in the third section. The final section deals briefly with the way out relying on the argument that law and order forces alone cannot tackle this problem.Keywords: Bangladesh, political Islam, violent extremism, women
Procedia PDF Downloads 1951772 Predictive Factors of Healthcare-Associated Infections and Antibiotic Use Patterns: A Cross-Sectional Survey at the Charles Nicolle Hospital of Tunis
Authors: Nouira Mariem, Ennigrou Samir
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Background and aims: Healthcare-associated infections (HAI) represent a major public health problem worldwide. They represent one of the most serious adverse events in health care. The objectives of our study were to estimate the prevalence of HAI at the Charles Nicolle Hospital (CNH) and to identify the main associated factors as well as to estimate the frequency of antibiotic use. Methods: It was a cross-sectional study at the CNH with a unique passage per department (October-December 2018). All patients present at the wards for more than 48 hours were included. All patients from outpatient consultations, emergency, and dialysis departments were not included. The site definitions of infections proposed by the Centers for Disease Control and Prevention (CDC) were used. Only clinically and/or microbiologically confirmed active HAIs were included. Results: A total of 318 patients were included, with a mean age of 52 years and a sex ratio (female/male) of 1.05. A total of 41 patients had one or more active HAIs, corresponding to a prevalence of 13.1% (95% CI: 9.3%-16.9%). The most frequent site infections were urinary tract infections and pneumonia. Multivariate analysis among adult patients (>=18 years) (n=261) revealed that infection on admission (p=0.01), alcoholism (p=0.01), high blood pressure (p=0.008), having at least one invasive device inserted (p=0.004), and history of recent surgery (p=0.03), increased the risk of HAIs significantly. More than 1 of 3 patients (35.4%) were under antibiotics on the day of the survey, of which more than half (57.4%) were under two or more types of antibiotics. Conclusion: The prevalence of HAIs and antibiotic prescriptions at the CNH were considerably high. An infection prevention and control committee, as well as the development of an antibiotic stewardship program with continuous monitoring using repeated prevalence surveys, must be implemented to limit the frequency of these infections effectively.Keywords: prevalence, healthcare associated infection, antibiotic, Tunisia
Procedia PDF Downloads 821771 A Study of The STEAM Toy Pedagogy Plan Evaluation for Elementary School
Authors: Wen-Te Chang, Yun-Hsin Pai
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Purpose: Based on the interdisciplinary of lower grade Elementary School with the integration of STEAM concept, related wooden toy and pedagogy plans were developed and evaluated. The research goal was to benefit elementary school education. Design/methodology/approach: The subjects were teachers from two primary school teachers and students from the department of design of universities in Taipei. Amount of 103participants (Male: 34, Female: 69) were invited to participate in the research. The research tools are “STEAM toy design” and “questionnaire of STEAM toy Pedagogy plan.” The STEAM toy pedagogy plans were evaluated after the activity of “The interdisciplinary literacy discipline guiding study program--STEAM wooden workshop,” Finding/results: The study results: (1) As factors analyzing of the questionnaire indicated the percentage on the major factors were cognition teaching 68.61%, affection 80.18% and technique 80.14%, with α=.936 of validity. The assessment tools were proved to be valid for STEAM pedagogy plan evaluation; (2) The analysis of the questionnaires investigation confirmed that the main effect of the teaching factors was not significant (affection = technique = cognition); however, the interaction between STEAM factors revealed to be significant (F (8, 1164) =5.51, p < .01); (3) The main effect of the six pedagogy plans was significant (climbing toy > bird toy = gondola toy > frog castanets > train toy > balancing toy), and an interactive effect between STEAM factors also reached a significant level, (F (8, 1164) =5.51, p < .01), especially on the artistic (A/ Art) aspect. Originality/value: The main achievement of research: (1) A pedagogy plan evaluation was successfully developed. (2) The interactive effect between the STEAM and the teaching factors reached a significant level. (3) An interactive effect between the STEAM factors and the pedagogy plans reached a significant level too.Keywords: STEAM, toy design, pedagogy plans, evaluation
Procedia PDF Downloads 2831770 Precious Gold and Diamond Accessories Versus False Fashion Diamond and Stained Accessories
Authors: Amira Yousef Mahrous Yousef
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This paper includes fast fashion verses sustainable fashion or slow fashion Indian based consumers. The expression ‘Fast fashion’ is generally referred to low-cost clothing collections that considered first hand copy of luxury brands, sometime interchangeably used with ‘mass fashion’. Whereas slow fashion or limited fashion which are consider to be more organic or eco-friendly. "Sustainable fashion is ethical fashion and here the consumer is just not design conscious but also social-environment conscious". Paper will deal with desire of young Indian consumer towards such luxury brands present in India, and their understanding of sustainable fashion, how to maintain the equilibrium between never newer fashion, style, and fashion sustainability. The green fashion market is growing rapidly as eco-friendly consumers are willing to expand their organic lifestyle to include clothing. With an increasing share of fashion consumers globally, Indian consumers are observed to consider the social and environmental ethics while making purchasing decisions. While some research clearly identifies the efforts of responsible consumers towards green fashion, some argue that fashion-orientated consumers who are sensitive towards environment do not actively participate towards supporting green fashion. This study aims to analyze the current perception of green fashion among Indian consumers. A small-scale exploratory study is conducted where consumers’ perception of green fashion is examined followed by an analysis of translation of this perception into purchase decision making. This research paper gives insight into consumer awareness on green fashion and provides scope towards the expansion of ethical fashion consumption .Keywords: inclusions, temperature gradient, HPHT synthetic fibers, polyamide fibers, fiber volume, compressive strength. gold nano clusters, copper ions, wool keratin, fluorescence
Procedia PDF Downloads 481769 Assessment of the Work-Related Stress and Associated Factors among Sanitation Workers in Public Hospitals during COVID-19, Addis Ababa, Ethiopia
Authors: Zerubabel Mihret
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Background: Work-related stress is a pattern of reactions to work demands unmatched by worker’s knowledge, skills, or abilities. Healthcare institutions are considered high-risk and intensive work areas for work-related stress. However, there is the nonexistence of clear and strong data about the magnitude of work-related stress on sanitation workers in hospitals in Ethiopia. The aim of this study was to determine the magnitude of work-related stress among sanitation workers in public hospitals during COVID-19 in Addis Ababa, Ethiopia. Methods: Institution-based cross-sectional study was conducted from October 2021 to February 2022 among 494 sanitation workers who were selected from 4 hospitals. HSE (Health and Safety Executive of UK) standard data collection tool was used, and an interviewer-administered questionnaire was used to collect the data using KOBO collect application. The collected data were cleaned and analyzed using SPSS version 20.0. Both binary and multivariable logistic regression analyses were done to identify important factors having an association with work-related stress. Variables with p-value ≤ 0.25 in the bivariate analysis were entered into the multivariable logistic regression model. A statistically significant level was declared at a p-value ≤ 0.05. Results: This study revealed that the magnitude of work-related stress among sanitation workers was 49.2% (95% CI 45-54). Significant proportions (72.7%) of sanitation workers were dissatisfied with their current job. Sex, age, experience, and chewing khat were significantly associated with work-related stress. Conclusion: Work-related stress is significantly high among sanitation workers. Sex, age, experience, and chewing khat were identified as factors associated with work-related stress. Intervention program focusing on the prevention and control of stress is desired by hospitals.Keywords: work-related stress, sanitation workers, Likert scale, public hospitals, Ethiopia
Procedia PDF Downloads 831768 Experimental Analysis for the Inlet of the Brazilian Aerospace Vehicle 14-X B
Authors: João F. A. Martos, Felipe J. Costa, Sergio N. P. Laiton, Bruno C. Lima, Israel S. Rêgo, Paulo P. G. Toro
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Nowadays, the scramjet is a topic that has attracted the attention of several scientific communities (USA, Australia, Germany, France, Japan, India, China, Russia), that are investing in this in this type of propulsion system due its interest to facilitate access to space and reach hypersonic speed, who have invested in this type of propulsion due to the interest in facilitating access to space. The Brazilian hypersonic scramjet aerospace vehicle 14-X B is a technological demonstrator of a hypersonic airbreathing propulsion system based on the supersonic combustion (scramjet) intended to be tested in flight into the Earth's atmosphere at 30 km altitude and Mach number 7. The 14-X B has been designed at the Prof. Henry T. Nagamatsu Laboratory of Aerothermodynamics and Hypersonics of the Institute for Advanced Studies (IEAv) in Brazil. The IEAv Hypersonic Shock Tunnel, named T3, is a ground-test facility able to reproduce the flight conditions as the Mach number as well as pressure and temperature in the test section close to those encountered during the test flight of the vehicle 14-X B into design conditions. A 1-m long stainless steel 14-X B model was experimentally investigated at T3 Hypersonic Shock Tunnel, for freestream Mach number 7. Static pressure measurements along the lower surface of the 14-X B model, along with high-speed schlieren photographs taken from the 5.5° leading edge and the 14.5° deflection compression ramp, provided experimental data that were compared to the analytical-theoretical solutions and the computational fluid dynamics (CFD) simulations. The results show a good qualitative agreement, and in consequence demonstrating the importance of these methods in the project of the 14-X B hypersonic aerospace vehicle.Keywords: 14-X, CFD, hypersonic, hypersonic shock tunnel, scramjet
Procedia PDF Downloads 3591767 Effects of Blood Pressure According to Age on End-Stage Renal Disease Development in Diabetes Mellitus Patients: A Nationwide Population-Based Cohort Study
Authors: Eun Hui Bae, Sang Yeob Lim, Bongseong Kim, Tae Ryom Oh, Su Hyun Song, Sang Heon Suh, Hong Sang Choi, Eun Mi Yang, Chang Seong Kim, Seong Kwon Ma, Kyung-Do Han, Soo Wan Kim
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Background: Recent hypertension guidelines have recommended lower blood pressure (BP) targets in high-risk patients. However, there are no specific guidelines based on age or systolic and diastolic blood pressure (SBP and DBP, respectively). We aimed to assess the effects of age-related BP on the development of end-stage renal disease (ESRD) in patients with diabetes. Methods: A total of 2,563,870 patients with DM aged >20 years were selected from the Korean National Health Screening Program from 2009 to 2012 and followed up until the end of 2019. Participants were categorized into age and BP groups, and the hazard ratios (HRs) for ESRD were calculated. Results: During a median follow-up of 7.15 years, the incidence rates of ESRD increased with increasing SBP and DBP. The HR for ESRD was the highest in patients younger than 40 years of age with DBP ≥ 100 mmHg. The effect of SBP and DBP on ESRD development was attenuated with age (interaction p-value was <0.0001 for age and SBP and 0.0022 for age and DBP). The subgroup analysis for sex, anti-hypertension medication, and history of chronic kidney disease (CKD) showed higher HRs for ESRD among males younger than 40 years, not taking anti-hypertension medications and CKD compared to those among females older than 40 years, anti-hypertension medication and non-CKD groups. Conclusions: Higher SBP and DBP increase the risk of developing ESRD in patients with diabetes, and in particular, younger individuals face greater risk. Therefore, intensive BP management is warranted in younger patients to prevent ESRD.Keywords: hypertension, young adult, end-stage renal disease, diabetes mellitus, chronic kidney disease, blood pressure
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