Search results for: role of institution
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 10710

Search results for: role of institution

3690 African Women in Power: An Analysis of the Representation of Nigerian Business Women in Television

Authors: Ifeanyichukwu Valerie Oguafor

Abstract:

Women generally have been categorized and placed under the chain of business industry, sometimes highly regarded and other times merely. The social construction of womanhood does not in all sense support a woman going into business, let alone succeed in it because it is believed that it a man’s world. In a typical patriarchal setting, a woman is expected to know nothing more domestic roles. For some women, this is not the case as they have been able to break these barriers to excel in business amidst these social setting and stereotypes. This study examines media representation of Nigerians business women, using content analysis of TV interviews as media text, framing analysis as an approach in qualitative methodology, The study further aims to analyse media frames of two Nigerian business women: FolorunshoAlakija, a business woman in the petroleum industry with current net worth 1.1 billion U.S dollars, emerging as the richest black women in the world 2014. MosunmolaAbudu, a media magnate in Nigeria who launched the first Africa’s global black entertainment and lifestyle network in 2013. This study used six predefined frames: the business woman, the myth of business women, the non-traditional woman, women in leading roles, the family woman, the religious woman, and the philanthropist woman to analyse the representation of Nigerian business women in the media. The analysis of the aforementioned frames on TV interviews with these women reveals that the media perpetually reproduces existing gender stereotype and do not challenge patriarchy. Women face challenges in trying to succeed in business while trying to keep their homes stable. This study concludes that the media represent and reproduce gender stereotypes in spite of the expectation of empowering women. The media reduces these women’s success insignificant rather than a role model for women in society.

Keywords: representation of business women in the media, business women in Nigeria, framing in the media, patriarchy, women's subordination

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3689 A Study of 3 Different Reintroduction Regimens in Anti-Tubercular Therapy-Induced Hepatitis in Extra-Pulmonary Tuberculosis

Authors: Alpana Meena

Abstract:

Background: Tuberculosis is one of the major causes of death in south-east nations. Anti-TB–induced hepatotoxicity (AIH) is associated with a mortality of 6%–12%. The risk is increased when the drugs are combined. Reintroduction of anti-tuberculosis drugs in patients with AIH has never been studied systematically. The present study was planned to see the clinical profile of patients of AIH and the response to reintroduction of therapy. Methods: The trial was conducted in the Department of Medicine, Maulana Azad Medical College and associated Lok Nayak Hospital, on 32 patients with extra-pulmonary tuberculosis who developed AIH. Patients were randomly allocated into 3 groups. In group 1- Isoniazid (INH) and Rifampicin (RIF) were given at full dosages (weight calculated) from day 1. In group 2- RIF was given at maximum dosage from day 1 and INH at maximum dosage from day 8. In group 3- INH was given at maximum dosage from day 1 and RIF at maximum dosage from day 8. Pyrazinamide was added when above regimens were tolerated. Results: The mean age of presentation was 29.37±13.497 years. The incidence was found to be highest in patients with tubercular meningitis (41%) followed by abdominal, pericardial, disseminated, spinal, and lymph nodes. The mean latent period for development of AIH was 7.84 days ± 6.149 days and the median normalization days for LFT’s was 8.81 ± 4.22 days (3-21). In the study, 21% patients had recurrence of AIH with majority of patients having tolerated the reintroduction of drugs. Pyrazinamide was introduced after establishing isoniazid and rifampicin safety, thus emphasizing the role of gradual reintroduction of ATT to avoid the combined effects of hepatotoxicity. Conclusion: To conclude, the recurrence rate of hepatotoxicity was not statistically significant between the three groups studied (p > 0.05), and thus all 3 hepatotoxic drugs can be reintroduced safely in patients developing AIH.

Keywords: anti-tubercular therapy induced hepatotoxicity, extra-pulmonary tuberculosis, reintroduction regimens, risk factors

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3688 An Evaluative Study of Services Provided in Community Based Rehabilitation Centres in Jordan

Authors: Wesam Darawsheh

Abstract:

Purpose: There is an absence of studies directed to evaluate the effectiveness of Community Based Rehabilitation (CBR) programs in Jordan. This research study is aimed at investigating the effectiveness of the services of CBR programmes in Jordan. Method: A questionnaire anonymized survey was carried out with forty-seven participants (stakeholders and volunteers) from four CBR centres in Jordan. It comprised eighteen questions that collected both qualitative and quantitative data with both closed- and open-ended questions. The survey assessed participants’ knowledge of CBR and perception of the effectiveness of services provided. The quantitative data were analyzed using SPSS Version 22.0 (2016, IBM Corporation New York). Qualitative data were analyzed through thematic content and analysis and open coding to identify emergent themes. Results: The ROC curve revealed that the AUC for questions of the survey to be (AUC=0.846) which indicated a good specificity and sensitivity of the questions of the survey. The MANOVA revealed insignificant results in the effect of the CBR site (p= 0.157), and the level of education of participants (p=0.549), on the perception of the effectiveness of CBR services. There were insignificant differences between the scores of PWDs and volunteers (p=0.781). 40.4% evaluated the effectiveness of CBR services to be low. This mainly stemmed out from the lack of efforts of the CBR programmes to raise the knowledge of the local community about CBR, disability and the role toward PWDs. Conclusions: A speculation for priorities of CBR programmes in Jordan was offered where efforts need to be directed at promoting livelihood and the empowerment components, in order to actualize the main three principles of CBR mainly by promoting multispectral collaboration as a way of operation.

Keywords: community based rehabilitation (CBR), people with disabilities (PWDS), CBR centres, rehabilitation services, Jordan, mixed-methods, evaluative study

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3687 Application of Adaptive Architecture in Building Technologies: A Case Study of Neuhoff Site in Nashville, Tennessee

Authors: Shohreh Moshiri, Hossein Alimohammadi

Abstract:

Building construction has a great impact on climate change. Adaptive design strategies were developed to provide new life and purpose to old buildings and create new environments with economic benefits to meet resident needs. The role of smart material systems is undeniable in providing adaptivity of the architectural environments and their effects on creating better adaptive building environments. In this research, a case study named Neuhoff site located near Cumberland River in the Germantown neighborhood in the city of Nashville, Tennessee, was considered. This building in the early 1920s was constructed as a meat-packing facility and then served as a mixed-use space; however, New City has partnered with world-class architects to reinvent this site to be changed to mixed-use waterfront development. The future office space will be designed with LEED certification as a goal. Environmentally friendly sensitive materials and designs will offer for all adaptive reuse of the building. The smart materials and their applications, especially in the field of building technology and architecture, were emphasized in providing a renovation plan for the site. The advantages and qualities of smart material systems were targeted to explore in this research on the field of architecture. Also, this research helps to understand better the effects of smart material systems on the construction and design processes, exploration of the way to make architecture with better adaptive characteristics, plus provide optimal environmental situations for the users, which reflect on the climatic, structural, and architectural performances.

Keywords: adaptive architecture, building technology, case study, smart material systems

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3686 The Role of the Urban Renewal Projects on the Reshaping of the Cities in Izmir, Turkey

Authors: Sibel Ecemis Kilic, Neslihan Karatas

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The concept of urban renewal came up with interventions to the urban areas which have social and economic problems aimed at gaining the city. In Turkey after 2000, urban renewal has become a frequent topic on the agenda; regulations have been developed in this regard. Urban renewal project would be a focal point for the formation of the city in the near future. The future of the city is directly related to how to achieve these applications. Urban renewal policies will be decisive in the positive or negative development of the potential of the existing renewal process. Urban renewal is seen as a refreshing new planned action for reshaping unplanned and uncontrolled growth of big cities/metropolitan areas. In this context, Izmir is one of the largest metropolitan areas which came on the agenda of urban renewal application in the recent period. Izmir, which is the third largest city of Turkey, is an important trade and port city. The city, located west of Turkey, is a gate opening to Europe. In particular, continued its development rapidly after the Republican Period, it has become an important big city today. Assessment of the current situation shows that the majority of existing residential areas was formed with squatters and unplanned settlements in Izmir city center. Therefore, an important part of these areas have significant problems in terms of the quality of life, safety, and environmental quality. Legal residential areas which have had developed before 2000 is seen inadequate security in terms of an earthquake. In this study, the central policies in Turkey and local policies in İzmir about urban renewal will be considered. In addition, urban renewal projects that are being implemented or applied in Izmir were discussed and suggestions will be developed in accordance with this policy.

Keywords: urban transformation, Izmir, urban planning, urban renewal

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3685 Water Resources Green Efficiency in China: Evaluation, Spatial Association Network Structure Analysis, and Influencing Factors

Authors: Tingyu Zhang

Abstract:

This paper utilizes the Super-SBM model to assess water resources green efficiency (WRGE) among provinces in China and investigate its spatial and temporal features, based on the characteristic framework of “economy-environment-society.” The social network analysis is employed to examine the network pattern and spatial interaction of WRGE. Further, the quadratic assignment procedure method is utilized for examining the influencing factors of the spatial association of WRGE regarding “relationship.” The study reveals that: (1) the spatial distribution of WRGE demonstrates a distribution pattern of Eastern>Western>Central; (2) a remarkable spatial association exists among provinces; however, no strict hierarchical structure is observed. The internal structure of the WRGE network is characterized by the feature of "Eastern strong and Western weak". The block model analysis discovers that the members of the “net spillover” and “two-way spillover” blocks are mostly in the eastern and central provinces; “broker” block, which plays an intermediary role, is mostly in the central provinces; and members of the “net beneficiary” block are mostly in the western region. (3) Differences in economic development, degree of urbanization, water use environment, and water management have significant impacts on the spatial connection of WRGE. This study is dedicated to the realization of regional linkages and synergistic enhancement of WRGE, which provides a meaningful basis for building a harmonious society of human and water coexistence.

Keywords: water resources green efficiency, super-SBM model, social network analysis, quadratic assignment procedure

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3684 The Impact of Digital Inclusive Finance on the High-Quality Development of China's Export Trade

Authors: Yao Wu

Abstract:

In the context of financial globalization, China has put forward the policy goal of high-quality development, and the digital economy, with its advantage of information resources, is driving China's export trade to achieve high-quality development. Due to the long-standing financing constraints of small and medium-sized export enterprises, how to expand the export scale of small and medium-sized enterprises has become a major threshold for the development of China's export trade. This paper firstly adopts the hierarchical analysis method to establish the evaluation system of high-quality development of China's export trade; secondly, the panel data of 30 provinces in China from 2011 to 2018 are selected for empirical analysis to establish the impact model of digital inclusive finance on the high-quality development of China's export trade; based on the analysis of heterogeneous enterprise trade model, a mediating effect model is established to verify the mediating role of credit constraint in the development of high-quality export trade in China. Based on the above analysis, this paper concludes that inclusive digital finance, with its unique digital and inclusive nature, alleviates the credit constraint problem among SMEs, enhances the binary marginal effect of SMEs' exports, optimizes their export scale and structure, and promotes the high-quality development of regional and even national export trade. Finally, based on the findings of this paper, we propose insights and suggestions for inclusive digital finance to promote the high-quality development of export trade.

Keywords: digital inclusive finance, high-quality development of export trade, fixed effects, binary marginal effects

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3683 Nurse Practitioner Led Pediatric Primary Care Clinic in a Tertiary Care Setting: Improving Access and Health Outcomes

Authors: Minna K. Miller, Chantel. E. Canessa, Suzanna V. McRae, Susan Shumay, Alissa Collingridge

Abstract:

Primary care provides the first point of contact and access to health care services. For the pediatric population, the goal is to help healthy children stay healthy and to help those that are sick get better. Primary care facilitates regular well baby/child visits; health promotion and disease prevention; investigation, diagnosis and management of acute and chronic illnesses; health education; both consultation and collaboration with, and referral to other health care professionals. There is a protective association between regular well-child visit care and preventable hospitalization. Further, low adherence to well-child care and poor continuity of care are independently associated with increased risk of hospitalization. With a declining number of family physicians caring for children, and only a portion of pediatricians providing primary care services, it is becoming increasingly difficult for children and their families to access primary care. Nurse practitioners are in a unique position to improve access to primary care and improve health outcomes for children. Limited literature is available on the nurse practitioner role in primary care pediatrics. The purpose of this paper is to describe the development, implementation and evaluation of a Nurse Practitioner-led pediatric primary care clinic in a tertiary care setting. Utilizing the participatory, evidence-based, patient-focused process for advanced practice nursing (PEPPA framework), this paper highlights the results of the initial needs assessment/gap analysis, the new service delivery model, populations served, and outcome measures.

Keywords: access, health outcomes, nurse practitioner, pediatric primary care, PEPPA framework

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3682 Design and Implementation of Collaborative Editing System Based on Physical Simulation Engine Running State

Authors: Zhang Songning, Guan Zheng, Ci Yan, Ding Gangyi

Abstract:

The application of physical simulation engines in collaborative editing systems has an important background and role. Firstly, physical simulation engines can provide real-world physical simulations, enabling users to interact and collaborate in real time in virtual environments. This provides a more intuitive and immersive experience for collaborative editing systems, allowing users to more accurately perceive and understand various elements and operations in collaborative editing. Secondly, through physical simulation engines, different users can share virtual space and perform real-time collaborative editing within it. This real-time sharing and collaborative editing method helps to synchronize information among team members and improve the efficiency of collaborative work. Through experiments, the average model transmission speed of a single person in the collaborative editing system has increased by 141.91%; the average model processing speed of a single person has increased by 134.2%; the average processing flow rate of a single person has increased by 175.19%; the overall efficiency improvement rate of a single person has increased by 150.43%. With the increase in the number of users, the overall efficiency remains stable, and the physical simulation engine running status collaborative editing system also has horizontal scalability. It is not difficult to see that the design and implementation of a collaborative editing system based on physical simulation engines not only enriches the user experience but also optimizes the effectiveness of team collaboration, providing new possibilities for collaborative work.

Keywords: physics engine, simulation technology, collaborative editing, system design, data transmission

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3681 Investigation of Leptospira Infection in Stray Animals in Thailand: Leptospirosis Risk Reduction in Human

Authors: Ruttayaporn Ngasaman, Saowakon Indouang, Usa Chethanond

Abstract:

Leptospirosis is a public health concern zoonosis in Thailand. Human and animals are often infected by contact with contaminated water. The infected animals play an important role in leptospira infection for both human and other hosts via urine. In humans, it can cause a wide range of symptoms, some of which may present mild flu-like symptoms including fever, vomiting, and jaundice. Without treatment, Leptospirosis can lead to kidney damage, meningitis, liver failure, respiratory distress, and even death. The prevalence of leptospirosis in stray animals in Thailand is unknown. The aim of this study was to investigate leptospira infection in stray animals including dogs and cats in Songkhla province, Thailand. Total of 434 blood samples were collected from 370 stray dogs and 64 stray cats during the population control program from 2014 to 2018. Screening test using latex agglutination for the detection of antibodies against Leptospira interrogans in serum samples shows 29.26% (127/434) positive. There were 120 positive samples of stray dogs and 7 positive samples of stray cats. Detection by polymerase chain reaction specific to LipL32 gene of Leptospira interrogans showed 1.61% (7/434) positive. Stray cats (5/64) show higher prevalence than stray dogs (2/370). Although active infection was low detected, but seroprevalence was high. This result indicated that stray animals were not active infection during sample collection but they use to get infected or in a latent period of infection. They may act as a reservoir for domestic animals and human in which stay in the same environment. In order to prevent and reduce the risk of leptospira infection in a human, stray animals should be done health checking, vaccination, and disease treatment.

Keywords: leptospirosis, stray animals, risk reduction, Thailand

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3680 Low-Cost Monitoring System for Hydroponic Urban Vertical Farms

Authors: Francesco Ruscio, Paolo Paoletti, Jens Thomas, Paul Myers, Sebastiano Fichera

Abstract:

This paper presents the development of a low-cost monitoring system for a hydroponic urban vertical farm, enabling its automation and a quantitative assessment of the farm performance. Urban farming has seen increasing interest in the last decade thanks to the development of energy efficient and affordable LED lights; however, the optimal configuration of such systems (i.e. amount of nutrients, light-on time, ambient temperature etc.) is mostly based on the farmers’ experience and empirical guidelines. Moreover, even if simple, the maintenance of such systems is labor intensive as it requires water to be topped-up periodically, mixing of the nutrients etc. To unlock the full potential of urban farming, a quantitative understanding of the role that each variable plays in the growth of the plants is needed, together with a higher degree of automation. The low-cost monitoring system proposed in this paper is a step toward filling this knowledge and technological gap, as it enables collection of sensor data related to water and air temperature, water level, humidity, pressure, light intensity, pH and electric conductivity without requiring any human intervention. More sensors and actuators can also easily be added thanks to the modular design of the proposed platform. Data can be accessed remotely via a simple web interface. The proposed platform can be used both for quantitatively optimizing the setup of the farms and for automating some of the most labor-intensive maintenance activities. Moreover, such monitoring system can also potentially be used for high-level decision making, once enough data are collected.

Keywords: automation, hydroponics, internet of things, monitoring system, urban farming

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3679 Flexible Furniture in Urban Open Spaces: A Tool to Achieve Social Sustainability

Authors: Mahsa Ghafouri, Guita Farivarsadri

Abstract:

In urban open spaces, furniture plays a crucial role in meeting various needs of the users over time. Furniture consists of elements that not only can facilitate physical needs individually but also fulfill social, psychological, and cultural demands on an urban scale. Creating adjustable urban spaces and using flexible furniture can provide the possibility of using urban spaces for a wide range of uses and activities and allow the engagement of users with distinct abilities and limitations in these activities. Flexibility in urban furniture can be seen as designing a number of modular components that are movable, expandable, adjustable, and changeable to accommodate various functions. Although there is a great amount of research related to flexibility and its distinct insights into achieving spaces that can cope with changing demands, this fundamental issue is often neglected in the design of urban furniture. However, in the long term, to address changing public needs over time, it can be logical to bring this quality into the design process to make spaces that can be sustained for a long time. This study aims to first introduce diverse kinds of flexible furniture that can be designed for urban public spaces and then to realize how this flexible furniture can improve the quality of public open spaces and social interaction and make them more adaptable over time and, as a result, achieve social sustainability. This research is descriptive and is mainly based on an extensive literature review and the analysis and classification of existing examples around the world. This research tends to illustrate various kinds of approaches that can help designers create flexible furniture to enhance the sustainability and quality of urban open spaces and, in this way, act as a guide for urban designers in this respect.

Keywords: flexible furniture, flexible design, urban open spaces, adaptability, moveability, social sustainability

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3678 The Effect of the Epstein-Barr Virus on the Development of Multiple Sclerosis

Authors: Sina Mahdavi

Abstract:

Background and Objective: Multiple sclerosis (MS) is the most common inflammatory autoimmune disease of the central nervous system (CNS) that affects the myelination process in the CNS. Complex interactions of various "environmental or infectious" factors may act as triggers in autoimmunity and disease progression. The association between viral infections, especially Epstein-Barr virus (EBV) and MS, is one potential cause that is not well understood. In this study, we aim to summarize the available data on EBV infection in MS disease progression. Materials and Methods: For this study, the keywords "Multiple sclerosis," "Epstein-Barr virus," and "central nervous system" in the databases PubMed, Google Scholar, Sid, and MagIran between 2016 and 2022 were searched, and 14 articles were chosen, studied, and analyzed. Results: Demyelinated lesions isolated from MS patients contain EBNAs from EBV proteins. The EBNA1 domain contains a pentapeptide fragment identical to B-crystallin, a heat shock peptide, that is increased in peripheral B cells in response to B-crystallin infection, resulting in myelin-directed autoimmunity mediated by proinflammatory T cells. EBNA2, which is involved in the regulation of viral transcription, may enhance transcription from MS risk loci. A 7-fold increase in the risk of MS has been observed in EBV infection with HLA-DR15 synergy. Conclusion: EBV infection along with a variety of specific genetic risk alleles, cause inflammatory cascades in the CNS by infected B cells. There is a high expression of EBV during the course of MS, which indicates the relationship between EBV and MS, that this virus can play a role in the development of MS by creating an inflammatory state. Therefore, measures to modulate the expression of EBV may be effective in reducing inflammatory processes in demyelinated areas of MS patients.

Keywords: multiple sclerosis, Epstein-Barr virus, central nervous system, EBNAs

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3677 Aspects and Studies of Fractal Geometry in Automatic Breast Cancer Detection

Authors: Mrinal Kanti Bhowmik, Kakali Das Jr., Barin Kumar De, Debotosh Bhattacharjee

Abstract:

Breast cancer is the most common cancer and a leading cause of death for women in the 35 to 55 age group. Early detection of breast cancer can decrease the mortality rate of breast cancer. Mammography is considered as a ‘Gold Standard’ for breast cancer detection and a very popular modality, presently used for breast cancer screening and detection. The screening of digital mammograms often leads to over diagnosis and a consequence to unnecessary traumatic & painful biopsies. For that reason recent studies involving the use of thermal imaging as a screening technique have generated a growing interest especially in cases where the mammography is limited, as in young patients who have dense breast tissue. Tumor is a significant sign of breast cancer in both mammography and thermography. The tumors are complex in structure and they also exhibit a different statistical and textural features compared to the breast background tissue. Fractal geometry is a geometry which is used to describe this type of complex structure as per their main characteristic, where traditional Euclidean geometry fails. Over the last few years, fractal geometrics have been applied mostly in many medical image (1D, 2D, or 3D) analysis applications. In breast cancer detection using digital mammogram images, also it plays a significant role. Fractal is also used in thermography for early detection of the masses using the thermal texture. This paper presents an overview of the recent aspects and initiatives of fractals in breast cancer detection in both mammography and thermography. The scope of fractal geometry in automatic breast cancer detection using digital mammogram and thermogram images are analysed, which forms a foundation for further study on application of fractal geometry in medical imaging for improving the efficiency of automatic detection.

Keywords: fractal, tumor, thermography, mammography

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3676 Availability of TB Infection Control Plans at Rural Hospitals of South Africa

Authors: Takalani Tshitangano

Abstract:

Background: In Limpopo province the rate of new tuberculosis (TB) cases increase daily. The Infection Control (IC) plan is one of the essential actions for TB IC. This study aimed to establish the availability of these plans at health care facilities. Objectives: The objectives were to explore and describe the awareness and knowledge of health care workers (HCWs) of the availability and content of TB IC plan; and to identity the role of infection control committees from the perspective of HCWs. Method: A qualitative approach using a cross-sectional descriptive design was adopted. The target population was all HCWs from the seven hospitals of Vhembe district. A purposive sampling approach was used to select 57 participants. The approval to conduct this study was obtained from the relevant authorities and participants. Data were collected through seven focus group discussions comprising five to 10 members. An unstructured discussion guide was used to collect data, and an open-coding method was used to analyse the data. Lincoln and Guba’s criteria ensured trustworthiness of the study findings. Results: Findings revealed that HCWs were not aware of the availability and the information contained in the TB IC plans. No person was designated as TB IC officer at hospital level. There was lack of a TB IC Committee and teams as well as ineffective utilisation of those that did exist. Conclusions: It was concluded that if the TB IC plans are not available at health care facilities, then the TB IC practices implemented by HCWs vary, resulting in TB nosocomial infection transmission. It was recommended that the World Health Organisation’s TB IC plans be adopted and implemented in Vhembe district.

Keywords: health care workers' awareness, health care workers' knowledge, availability of TB infection control plans, rural hospitals

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3675 Influence of BaTiO₃ on the Biological Behaviour of Hydroxyapatite: Collagen Composites

Authors: Cristina Busuioc, Georgeta Voicu, Sorin-Ion Jinga

Abstract:

The human bone presents in its dry form piezoelectric properties, which means that a mechanical stress results in electric polarization and an applied electric field causes strain. The immediate consequence was the revealing of piezoelectricity role in bone remodelling, as well as the integration of ceramic materials with piezoelectric behaviour in the composition of unitary or composite biomaterials. Thus, we prepared hydroxyapatite - collagen hybrid materials with barium titanate addition in order to achieve a better osseointegration. Barium titanate powder synthesized by a combined sol-gel-hydrothermal method, commercial hydroxyapatite and laboratory extracted collagen gel were employed as starting materials. Before the composites, fabrication, the powder with piezoelectric features was characterized in detail from the compositional, structural, morphological and electrical point of view. The next step was to elucidate the influence of barium titanate presence especially on the biological properties of the final materials. The biocompatibility of the hybrid supports without or with piezoelectric addition was investigated on mouse osteoblast cells through LDH cytotoxicity assay, LIVE/DEAD cell viability assay, and MTT cell proliferation assay. All results indicated that the analysed materials do not exert cytotoxic effects and present the ability to sustain cell survival and to promote their proliferation. In conclusion, barium titanate nanoparticles exhibit a good biocompatibility and osteoinductive properties, while the derived composite materials based on hydroxyapatite as oxide phase and collagen as polymeric phase can be successfully used for tissue engineering applications.

Keywords: barium titanate, hybrid composites, piezoelectricity, tissue engineering

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3674 Expression of Tissue Plasminogen Activator in Transgenic Tobacco Plants by Signal Peptides Targeting for Delivery to Apoplast, Endoplasmic Reticulum and Cytosol Spaces

Authors: Sadegh Lotfieblisofla, Arash Khodabakhshi

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Tissue plasminogen activator (tPA) as a serine protease plays an important role in the fibrinolytic system and the dissolution of fibrin clots in human body. The production of this drug in plants such as tobacco could reduce its production costs. In this study, expression of tPA gene and protein targeting to different plant cell compartments, using various signal peptides has been investigated. For high level of expression, Kozak sequence was used after CaMV35S in the beginning of the gene. In order to design the final construction, Extensin, KDEL (amino acid sequence including Lys-Asp-Glu-Leu) and SP (γ-zein signal peptide coding sequence) were used as leader signals to conduct this protein into apoplast, endoplasmic reticulum and cytosol spaces, respectively. Cloned human tPA gene under the CaMV (Cauliflower mosaic virus) 35S promoter and NOS (Nopaline Synthase) terminator into pBI121 plasmid was transferred into tobacco explants by Agrobacterium tumefaciens strain LBA4404. The presence and copy number of genes in transgenic tobacco was proved by Southern blotting. Enzymatic activity of the rt-PA protein in transgenic plants compared to non-transgenic plants was confirmed by Zymography assay. The presence and amount of rt-PA recombinant protein in plants was estimated by ELISA analysis on crude protein extract of transgenic tobacco using a specific antibody. The yield of recombinant tPA in transgenic tobacco for SP, KDEL, Extensin signals were counted 0.50, 0.68, 0.69 microgram per milligram of total soluble proteins.

Keywords: tPA, recombinant, transgenic, tobacco

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3673 Mammographic Multi-View Cancer Identification Using Siamese Neural Networks

Authors: Alisher Ibragimov, Sofya Senotrusova, Aleksandra Beliaeva, Egor Ushakov, Yuri Markin

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Mammography plays a critical role in screening for breast cancer in women, and artificial intelligence has enabled the automatic detection of diseases in medical images. Many of the current techniques used for mammogram analysis focus on a single view (mediolateral or craniocaudal view), while in clinical practice, radiologists consider multiple views of mammograms from both breasts to make a correct decision. Consequently, computer-aided diagnosis (CAD) systems could benefit from incorporating information gathered from multiple views. In this study, the introduce a method based on a Siamese neural network (SNN) model that simultaneously analyzes mammographic images from tri-view: bilateral and ipsilateral. In this way, when a decision is made on a single image of one breast, attention is also paid to two other images – a view of the same breast in a different projection and an image of the other breast as well. Consequently, the algorithm closely mimics the radiologist's practice of paying attention to the entire examination of a patient rather than to a single image. Additionally, to the best of our knowledge, this research represents the first experiments conducted using the recently released Vietnamese dataset of digital mammography (VinDr-Mammo). On an independent test set of images from this dataset, the best model achieved an AUC of 0.87 per image. Therefore, this suggests that there is a valuable automated second opinion in the interpretation of mammograms and breast cancer diagnosis, which in the future may help to alleviate the burden on radiologists and serve as an additional layer of verification.

Keywords: breast cancer, computer-aided diagnosis, deep learning, multi-view mammogram, siamese neural network

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3672 Thermal Effects on Wellbore Stability and Fluid Loss in High-Temperature Geothermal Drilling

Authors: Mubarek Alpkiray, Tan Nguyen, Arild Saasen

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Geothermal drilling operations contain numerous challenges that are encountered to increase the well cost and nonproductive time. Fluid loss is one of the most undesirable troublesome that can cause well abandonment in geothermal drilling. Lost circulation can be seen due to natural fractures, high mud weight, and extremely high formation temperatures. This challenge may cause wellbore stability problems and lead to expensive drilling operations. Wellbore stability is the main domain that should be considered to mitigate or prevent fluid loss into the formation. This paper describes the causes of fluid loss in the Pamukoren geothermal field in Turkey. A geomechanics approach integration and assessment is applied to help the understanding of fluid loss problems. In geothermal drillings, geomechanics is primarily based on rock properties, in-situ stress characterization, the temperature of the rock, determination of stresses around the wellbore, and rock failure criteria. Since a high-temperature difference between the wellbore wall and drilling fluid is presented, temperature distribution through the wellbore is estimated and implemented to the wellbore stability approach. This study reviewed geothermal drilling data to analyze temperature estimation along the wellbore, the cause of fluid loss and stored electric capacity of the reservoir. Our observation demonstrates the geomechanical approach's significant role in understanding safe drilling operations on high-temperature wells. Fluid loss is encountered due to thermal stress effects around the borehole. This paper provides a wellbore stability analysis for a geothermal drilling operation to discuss the causes of lost circulation resulting in nonproductive time and cost.

Keywords: geothermal wells, drilling, wellbore stresses, drilling fluid loss, thermal stress

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3671 Biophysical Characterization of Archaeal Cyclophilin Like Chaperone Protein

Authors: Vineeta Kaushik, Manisha Goel

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Chaperones are proteins that help other proteins fold correctly, and are found in all domains of life i.e., prokaryotes, eukaryotes and archaea. Various comparative genomic studies have suggested that the archaeal protein folding machinery appears to be highly similar to that found in eukaryotes. In case of protein folding; slow rotation of peptide prolyl-imide bond is often the rate limiting step. Formation of the prolyl-imide bond during the folding of a protein requires the assistance of other proteins, termed as peptide prolyl cis-trans isomerases (PPIases). Cyclophilins constitute the class of peptide prolyl isomerases with a wide range of biological function like protein folding, signaling and chaperoning. Most of the cyclophilins exhibit PPIase enzymatic activity and play active role in substrate protein folding which classifies them as a category of molecular chaperones. Till date, there is not very much data available in the literature on archaeal cyclophilins. We aim to compare the structural and biochemical features of the cyclophilin protein from within the three domains to elucidate the features affecting their stability and enzyme activity. In the present study, we carry out in-silico analysis of the cyclophilin proteins to predict their conserved residues, sites under positive selection and compare these proteins to their bacterial and eukaryotic counterparts to predict functional divergence. We also aim to clone and express these proteins in heterologous system and study their biophysical characteristics in detail using techniques like CD and fluorescence spectroscopy. Overall we aim to understand the features contributing to the folding, stability and dynamics of the archaeal cyclophilin proteins.

Keywords: biophysical characterization, x-ray crystallography, chaperone-like activity, cyclophilin, PPIase activity

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3670 The Development Stages of Transformation of Water Policy Management in Victoria

Authors: Ratri Werdiningtyas, Yongping Wei, Andrew Western

Abstract:

The status quo of social-ecological systems is the results of not only natural processes but also the accumulated consequence of policies applied in the past. Often water management objectives are challenging and are only achieved to a limited degree on the ground. In choosing water management approaches, it is important to account for current conditions and important differences due to varied histories. Since the mid-nineteenth century, Victorian water management has evolved through a series of policy regime shifts. The main goal of this research to explore and identify the stages of the evolution of the water policy instruments as practiced in Victoria from 1890-2016. This comparative historical analysis has identified four stages in Victorian policy instrument development. In the first stage, the creation of policy instruments aimed to match the demand and supply of the resource (reserve condition). The second stage begins after natural system alone failed to balance supply and demand. The focus of the policy instrument shifted to an authority perspective in this stage. Later, the increasing number of actors interested in water led to another change in policy instrument. The third stage focused on the significant role of information from different relevant actors. The fourth and current stage is the most advanced, in that it involved the creation of a policy instrument for synergizing the previous three focal factors: reserve, authority, and information. When considering policy in other jurisdiction, these findings suggest that a key priority should be to reflect on the jurisdictions current position among these four evolutionary stages and try to make improve progressively rather than directly adopting approaches from elsewhere without understanding the current position.

Keywords: policy instrument, policy transformation, socio-ecolgical system, water management

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3669 Examining the Relations among Autobiographical Memory Recall Types, Quality of Descriptions, and Emotional Arousal in Psychotherapy for Depression

Authors: Jinny Hong, Jeanne C. Watson

Abstract:

Three types of autobiographical memory recall -specific, episodic, and generic- were examined in relation to the quality of descriptions and in-session levels of emotional arousal. Correlational analyses and general estimating equation were conducted to test the relationships between 1) quality of descriptions and type of memory, 2) type of memory and emotional arousal, and 3) quality of descriptions and emotional arousal. The data was transcripts drawn from an archival randomized-control study comparing cognitive-behavioral therapy and emotion-focused therapy in a 16-week treatment for depression. Autobiographical memory recall segments were identified and sorted into three categories: specific, episodic, and generic. Quality of descriptions of these segments was then operationalized and measured using the Referential Activity Scale, and each memory segment was rated on four dimensions: concreteness, specificity, clarity, and overall imagery. Clients’ level of emotional arousal for each recall was measured using the Client’s Expression Emotion Scale. Contrary to the predictions, generic memories are associated with higher emotional arousal ratings and descriptive language ratings compared to specific memories. However, a positive relationship emerged between the quality of descriptions and expressed emotional arousal, indicating that the quality of descriptions in which memories are described in sessions is more important than the type of memory recalled in predicting clients’ level of emotional arousal. The results from this study provide a clearer understanding of the role of memory recall types and use of language in activating emotional arousal in psychotherapy sessions in a depressed sample.

Keywords: autobiographical memory recall, emotional arousal, psychotherapy for depression, quality of descriptions, referential activity

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3668 Feasibility Study of Mine Tailing’s Treatment by Acidithiobacillus thiooxidans DSM 26636

Authors: M. Gómez-Ramírez, A. Rivas-Castillo, I. Rodríguez-Pozos, R. A. Avalos-Zuñiga, N. G. Rojas-Avelizapa

Abstract:

Among the diverse types of pollutants produced by anthropogenic activities, metals represent a serious threat, due to their accumulation in ecosystems and their elevated toxicity. The mine tailings of abandoned mines contain high levels of metals such as arsenic (As), zinc (Zn), copper (Cu), and lead (Pb), which do not suffer any degradation process, they are accumulated in environment. Abandoned mine tailings potentially could contaminate rivers and aquifers representing a risk for human health due to their high metal content. In an attempt to remove the metals and thereby mitigate the environmental pollution, an environmentally friendly and economical method of bioremediation has been introduced. Bioleaching has been actively studied over the last several years, and it is one of the bioremediation solutions used to treat heavy metals contained in sewage sludge, sediment and contaminated soil. Acidithiobacillus thiooxidans, an extremely acidophilic, chemolithoautotrophic, gram-negative, rod shaped microorganism, which is typically related to Cu mining operations (bioleaching), has been well studied for industrial applications. The sulfuric acid produced plays a major role in bioleaching. Specifically, Acidithiobacillus thiooxidans strain DSM 26636 has been able to leach Al, Ni, V, Fe, Mg, Si, and Ni contained in slags from coal combustion wastes. The present study reports the ability of A. thiooxidans DSM 26636 for the bioleaching of metals contained in two different mine tailing samples (MT1 and MT2). It was observed that Al, Fe, and Mn were removed in 36.3±1.7, 191.2±1.6, and 4.5±0.2 mg/kg for MT1, and in 74.5±0.3, 208.3±0.5, and 20.9±0.1 for MT2. Besides, < 1.5 mg/kg of Au and Ru were also bioleached from MT1; in MT2, bioleaching of Zn was observed at 55.7±1.3 mg/kg, besides removal of < 1.5 mg/kg was observed for As, Ir, Li, and 0.6 for Os in this residue. These results show the potential of strain DSM 26636 for the bioleaching of metals that came from different mine tailings.

Keywords: A. thiooxidans, bioleaching, metals, mine tailings

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3667 Integrated Modeling of Transformation of Electricity and Transportation Sectors: A Case Study of Australia

Authors: T. Aboumahboub, R. Brecha, H. B. Shrestha, U. F. Hutfilter, A. Geiges, W. Hare, M. Schaeffer, L. Welder, M. Gidden

Abstract:

The proposed stringent mitigation targets require an immediate start for a drastic transformation of the whole energy system. The current Australian energy system is mainly centralized and fossil fuel-based in most states with coal and gas-fired plants dominating the total produced electricity over the recent past. On the other hand, the country is characterized by a huge, untapped renewable potential, where wind and solar energy could play a key role in the decarbonization of the Australia’s future energy system. However, integrating high shares of such variable renewable energy sources (VRES) challenges the power system considerably due to their temporal fluctuations and geographical dispersion. This raises the concerns about flexibility gap in the system to ensure the security of supply with increasing shares of such intermittent sources. One main flexibility dimension to facilitate system integration of high shares of VRES is to increase the cross-sectoral integration through coupling of electricity to other energy sectors alongside the decarbonization of the power sector and reinforcement of the transmission grid. This paper applies a multi-sectoral energy system optimization model for Australia. We investigate the cost-optimal configuration of a renewable-based Australian energy system and its transformation pathway in line with the ambitious range of proposed climate change mitigation targets. We particularly analyse the implications of linking the electricity and transport sectors in a prospective, highly renewable Australian energy system.

Keywords: decarbonization, energy system modelling, renewable energy, sector coupling

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3666 Factors Affecting Access to Education: The Experiences of Parents of Children Who Are Deaf or Hard of Hearing

Authors: Hanh Thi My Nguyen

Abstract:

The purpose of this research is to examine the experiences of parents of children who are deaf or hard of hearing in supporting their children to access education in Vietnam. Parents play a crucial role in supporting their children to gain full access to education. It was widely reported that parents of those children confronted a range of problems to support their children to access education. To author’s best knowledge, there has been a lack of research exploring the experiences of those parents in literature. This research examines factors affecting those parents in supporting their children to access education. To conduct the study, qualitative approach using a phenomenological research design was chosen to explore the central phenomena. Ten parents of children who were diagnosed as deaf or hard of hearing and aged 6-9 years were recruited through the support of the Association of Parents of Children with Hearing Impairment. Participants were interviewed via telephone with a mix of open and closed questions; interviews were audio recorded, transcribed and thematically analysed. The research results show that there are nine main factors that affected the parents in this study in making decisions relating to education for their children including: lack of information resources, perspectives of those parents on communication approaches, the families’ financial capacity, the psychological impact on the participants after their children’ diagnosis, the attitude of family members, attitude of school administrators, lack of local schools and qualified teachers, and current education system for the deaf in Vietnam. Apart from those factors, the lack of knowledge of the participants’ partners about deaf education and the partners’ employment are barriers to educational access and successful communication with their child.

Keywords: access to education, deaf, hard of hearing, parents experience

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3665 Relation Between Marital Adjustment and Parenting: The Moderating Effect of Children´s Temperament

Authors: Ester Ato, Maria Angeles Fernández-Vilar, Maria Dolores Galián

Abstract:

The aim of this work was to analyze the relation between children´s effortful control, marital adjustment and parenting practices in a sample of 345 Spanish children aged between 6 and 8 years. Traditionally, the literature confirms that a higher level of marital conflict has been associated with less effective and less positive parenting, but there are few studies that include the effect that children´s effortful control exert to this relation. To measure marital adjustment, parenting practices and children’s temperament, parents were given the Marital Adjustment Test (MAT), the Spanish version of the PCRI (Parent-Child Relationship Inventory), and the TMCQ (Temperament in Middle Childhood Questionnaire). The results confirmed that higher marital satisfaction predicted more positive parenting practices, whereas lower marital adjustment scores predicted less parenting support and control. Using a statistical modeling approach, we tested a moderation model that revealed the moderating role of effortful control in the relation between marital adjustment and parenting. Concretely, higher marital satisfaction predicts higher parenting communication and involvement, but only in children with low levels of effortful control. Therefore, a difficult temperament interferes in a less negative way in the family system when parents are satisfied and united. And a better self-regulated child predicts more effective parenting practice regardless of the parents´ marital satisfaction. The clinical implications of the present findings should be considered. Specifically, difficult children must be detected and evaluated in community settings, such as school or community programs, in order to take into account the marital adjustment and parenting practices of their parents, and to be able to design adequate family interventions and prevent future pathologizing patterns.

Keywords: effortful control, marital adjustment, parenting, moderation

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3664 Factors Affecting the Formation of Architectural Space and Construction Systems in the Jordanian Vernacular Architecture

Authors: Mohannad Tarrad

Abstract:

The research deals with the beginnings of the vernacular Jordanian architecture since the establishment of the Jordanian state in the early nineteenth century until now, where the Jordanian architecture was based on the interactions of the Jordanian society with the surrounding environment, where the local materials available in the construction area were used, and the construction systems inherited from previous civilizations were used. The builders in Jordan relied on exchanging knowledge and transferring it from one generation to another, where they were able to formulate a construction style capable of responding to the requirement of architectural spaces, and each region of Jordan has its own way of building, as there are various geographical areas in Jordan, including agricultural, mountainous and desert areas. Then the research touched on a historical study of the architectural space and identifying the value of the architectural space in the Jordanian social life, which is related to the customs and traditions of a society influenced by the Arab Islamic civilization, and then the construction, the structural structure, its characteristics and the constituent elements of the building were defined in the vernacular l Jordanian architecture. From the structural point of view, and then to identify the structural materials used in the structural structure and the impact of the structural structure on the design from several aspects, leading to the interior space and the factors affecting it. The research aims to explain and clarify the interconnected design and construction solutions in the vernacular Jordanian architecture in a manner that respects the environmental context, taking into account the material cost of the building, where the financial situation of the home owner plays an important role in choosing the building material and construction method. Case studies from heritage buildings from several Jordanian regions will be analyzed to illustrate the idea of the research.

Keywords: construction systems, architectural space, environmental context, Jordanian architecture

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3663 Portuguese City Reconstructed from Public Space: The Example of the Requalification of Cacém Central Area

Authors: Rodrigo Coelho

Abstract:

As several authors have pointed out (such as Jordi Borja, or Oriol Bohigas), the necessity to “make center” presents itself not only as a imperative response to deal with the processes of dissolution of peripheral urbanization, as it should be assumed, from the point of view its symbolic and functional meaning, as a key concept to think and act on the enlarged city. The notion of re-centralization (successfully applied in urban periphery recompositions, such as in Barcelona or Lyon), understood from the redefinition of mobility, the strengthening of core functions, and from the creation or consolidation of urban fabrics (always articulated with policies of creation and redevelopment of public spaces), seems to become one of the key strategies over the challenge of making the city on the “city periphery”. The question we want to address in this paper concerns, essentially, the importance of public space in the (re) construction of the contemporary "shapeless city” sectors (which, in general, we associate to urban peripheries). We will seek demonstrate, from the analysis of a Portuguese case study–The Cacém Central Area requalification, integrated in Polis Program (National Program for Urban Rehabilitation and Environmental Improvement of Cities, released in 1999 by the Portuguese government), the conditions under which the public space project can act, subsequently, in the urban areas of recent formation, where, in many situations, the public space did not have a structuring role in its urbanization, seeing its presence reduced to a residual character. More specifically, we intend to demonstrate with this example the methodological and urban design aspects that led to the regeneration of a disqualified and degraded urban area, by intervening consistently and profoundly in public space (with well defined objectives and criteria, and framed in a more comprehensive strategy, attentive to the various scales of urban design).

Keywords: public space, urban design, urban regeneration, urban and regional studies

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3662 Triangular Libration Points in the R3bp under Combined Effects of Oblateness, Radiation and Power-Law Profile

Authors: Babatunde James Falaye, Shi Hai Dong, Kayode John Oyewumi

Abstract:

We study the e ffects of oblateness up to J4 of the primaries and power-law density pro file (PDP) on the linear stability of libration location of an in nitesimal mass within the framework of restricted three body problem (R3BP), by using a more realistic model in which a disc with PDP is rotating around the common center of the system mass with perturbed mean motion. The existence and stability of triangular equilibrium points have been explored. It has been shown that triangular equilibrium points are stable for 0 < μ < μc and unstable for μc ≤ μ ≤ 1/2, where c denotes the critical mass parameter. We find that, the oblateness up to J2 of the primaries and the radiation reduces the stability range while the oblateness up to J4 of the primaries increases the size of stability both in the context where PDP is considered and ignored. The PDP has an e ect of about ≈0:01 reduction on the application of c to Earth-Moon and Jupiter-Moons systems. We find that the comprehensive eff ects of the perturbations have a stabilizing proclivity. However, the oblateness up to J2 of the primaries and the radiation of the primaries have tendency for instability, while coecients up to J4 of the primaries have stability predisposition. In the limiting case c = 0, and also by setting appropriate parameter(s) to zero, our results are in excellent agreement with the ones obtained previously. Libration points play a very important role in space mission and as a consequence, our results have a practical application in space dynamics and related areas. The model may be applied to study the navigation and station-keeping operations of spacecraft (in nitesimal mass) around the Jupiter (more massive) -Callisto (less massive) system, where PDP accounts for the circumsolar ring of asteroidal dust, which has a cloud of dust permanently in its wake.

Keywords: libration points, oblateness, power-law density profile, restricted three-body problem

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3661 Maternity Care Model during Natural Disaster or Humanitarian Emegerncy Setting in Rural Pakistan

Authors: Humaira Maheen, Elizabeth Hoban, Catherine Bennette

Abstract:

Background: Globally, role of Community Health Workers (CHW) as front line disaster health work force is underutilized. Developing countries which are at risk of natural disasters or humanitarian emergencies should lay down effective strategies especially to ensure adequate access to maternity care during crisis situation by using CHW as they are local, trained, and most of them possess a good relationship with the community. The Minimum Initial Service Package (MISP) is a set of universal guidelines that addresses women’s reproductive health needs during the first phase of an emergency. According to the MISP, pregnant women should have access to a skilled birth attendant and adequate transportation arrangements so they can access a maternity care facility. Pakistan is one of the few countries which has been severely affected by a number of natural disaster as well as humanitarian emergencies in last decade. Pakistan has a young and structured National Disaster Management System in place, where District Authorities play a vital role in disaster management. The District Health Department develops the contingency health plan for an emergency situation and implements it under the existing district health human resources (health workers and medical staff at the health facility) and infrastructure (health care facilities). Methods: A mixed methods study was conducted in rural villages of Sindh adjacent to the river Indus, and included in-depth interviews with 15 women who gave birth during the floods, structured interviews with 668 women who were pregnant during 2010-2014, and in-depth interviews with 25 community health workers (CHW) and 30 key informants. Results: Women said that giving birth in the relief camps during the floods was one of the most challenging times of their life. The district health department didn’t make transportation arrangement for labouring women from relief camp to the nearest health care facility. As a result 91.2% women gave birth in temporary shelters with the help of a traditional birth attendant (Dai) with no clean physical space available to birth. Of the 332 women who were pregnant at the time of the floods, 26 had adverse birth outcomes; 10 had miscarriages, 14 had stillbirths and there were four neonatal deaths. Conclusion: The district health department was not able to provide access to adequate maternity care during according to the international standard during the floods in 2011. We propose a model where CHWs will be used as frontline maternity care providers during any emergency or disaster situations in Pakistan. A separate "birthing station" should be mandatory in all district relief camps, managed by CHWs. Community midwives (CMW) would and the Lady Health Workers (LHW) would provide antenatal and postnatal care alongside, vaccination for pregnant women, neonates and children under five. There must be an ambulance facility for emergency obstetric cases and all district health facilities should have at least two medical staff identified and trained for emergency obstetric management. The District Health Department must provide clean birthing kits and regular and emergency contraceptives in the relief camps. Methods: A mixed methods study was conducted in rural villages of Sindh adjacent to the river Indus, and included in-depth interviews with 15 women who gave birth during the floods, structured interviews with 668 women who were pregnant during 2010-2014, and in-depth interviews with 25 community health workers (CHW) and 30 key informants. Results: Women said that giving birth in the relief camps during the floods was one of the most challenging times of their life. Nearly 91.2% women gave birth in temporary shelters with the help of a traditional birth attendant (Dai) with no clean physical space available to birth, and the health camp was mostly accessed by men and always overcrowded. There was no obstetric trained medical staff in the health camps or transportation provided to take women with complications to the nearest health facility. The rate of adverse outcome following disaster was 22.2% (95% CI: 8.62% – 42.2%) amongst 27 women who did not evacuate as compare to 7.91% (95% CI: 5.03% – 11.8%) among 278 women who lived in relief camp study participants. There were 27 women who evacuated on pre-flood warning and had 0% rate of adverse outcome. Conclusion: We propose a model where CHWs will be used as frontline maternity care providers during any emergency or disaster situations in Pakistan. A separate "birthing station" should be mandatory in all district relief camps, managed by CHWs. Community midwives (CMW) would and the Lady Health Workers (LHW) would provide antenatal and postnatal care alongside, vaccination for pregnant women, neonates and children under five. There must be an ambulance facility for emergency obstetric cases and all district health facilities should have at least two medical staff identified and trained for emergency obstetric management. The District Health Department must provide clean birthing kits and regular and emergency contraceptives in the relief camps.

Keywords: natural disaster, maternity care model, rural, Pakistan, community health workers

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