Search results for: landscape character identify

Authors: Maciej Szeląg, Stanisław Fic

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The impact of elevated temperatures on the construction materials manifests in change of their physical and mechanical characteristics. Stresses and thermal deformations that occur inside the volume of the material cause its progressive degradation as temperature increase. Finally, the reactions and transformations of multiphase structure of cementitious composite cause its complete destruction. A particularly dangerous phenomenon is the impact of thermal shock – a sudden high temperature load. The thermal shock leads to a high value of the temperature gradient between the outer surface and the interior of the element in a relatively short time. The result of mentioned above process is the formation of the cracks and scratches on the material’s surface and inside the material. The article describes the use of computer image analysis techniques to identify and assess the structure of the cluster cracks on the surfaces of modified cement pastes, caused by thermal shock. Four series of specimens were tested. Two Portland cements were used (CEM I 42.5R and CEM I 52,5R). In addition, two of the series contained metakaolinite as a replacement for 10% of the cement content. Samples in each series were made in combination of three w/b (water/binder) indicators of respectively 0.4; 0.5; 0.6. Surface cracks of the samples were created by a sudden temperature load at 200°C for 4 hours. Images of the cracked surfaces were obtained via scanning at 1200 DPI; digital processing and measurements were performed using ImageJ v. 1.46r software. In order to examine the cracked surface of the cement paste as a system of closed clusters – the dispersal systems theory was used to describe the structure of cement paste. Water is used as the dispersing phase, and the binder is used as the dispersed phase – which is the initial stage of cement paste structure creation. A cluster itself is considered to be the area on the specimen surface that is limited by cracks (created by sudden temperature loading) or by the edge of the sample. To describe the structure of cracks two stereological parameters were proposed: A ̅ – the cluster average area, L ̅ – the cluster average perimeter. The goal of this study was to compare the investigated stereological parameters with the mechanical properties of the tested specimens. Compressive and tensile strength testes were carried out according to EN standards. The method used in the study allowed the quantitative determination of defects occurring in the examined modified cement pastes surfaces. Based on the results, it was found that the nature of the cracks depends mainly on the physical parameters of the cement and the intermolecular interactions on the dispersal environment. Additionally, it was noted that the A ̅/L ̅ relation of created clusters can be described as one function for all tested samples. This fact testifies about the constant geometry of the thermal cracks regardless of the presence of metakaolinite, the type of cement and the w/b ratio.

Keywords: cement paste, cluster cracks, elevated temperature, image analysis, metakaolinite, stereological parameters

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Authors: Helen Durgante, Mariana F. Sparremberger, Flavia C. Bernardes, Debora D. DellAglio

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Health promotion programmes for retirees, based on Positive Psychology perspectives for the development of strengths and virtues, demand broadened empirical investigation in Brazil. In the case of evidence-based applied research, it is suggested feasibility studies are conducted prior to efficacy trials of the intervention, in order to identify and rectify possible faults in the design and implementation of the intervention. The aim of this study was to evaluate the feasibility of a multicomponent Positive Psychology programme for health promotion of retirees, based on Cognitive Behavioural Therapy and Positive Psychology perspectives. The programme structure included six weekly group sessions (two hours each) encompassing strengths such as Values and self-care, Optimism, Empathy, Gratitude, Forgiveness, and Meaning of life and work. The feasibility criteria evaluated were: Demand, Acceptability, Satisfaction with the programme and with the moderator, Comprehension/Generalization of contents, Evaluation of the moderator (Social Skills and Integrity/Fidelity), Adherence, and programme implementation. Overall, 11 retirees (F=11), age range 54-75, from the metropolitan region of Porto Alegre-RS-Brazil took part in the study. The instruments used were: Qualitative Admission Questionnaire; Moderator Field Diary; the Programme Evaluation Form to assess participants satisfaction with the programme and with the moderator (a six-item 4-point likert scale), and Comprehension/Generalization of contents (a three-item 4-point likert scale); Observers’ Evaluation Form to assess the moderator Social Skills (a five-item 4-point likert scale), Integrity/Fidelity (a 10 item 4-point likert scale), and Adherence (a nine-item 5-point likert scale). Qualitative data were analyzed using content analysis. Descriptive statistics as well as Intraclass Correlations coefficients were used for quantitative data and inter-rater reliability analysis. The results revealed high demand (N = 55 interested people) and acceptability (n = 10 concluded the programme with overall 88.3% frequency rate), satisfaction with the program and with the moderator (X = 3.76, SD = .34), and participants self-report of Comprehension/Generalization of contents provided in the programme (X = 2.82, SD = .51). In terms of the moderator Social Skills (X = 3.93; SD = .40; ICC = .752 [IC = .429-.919]), Integrity/Fidelity (X = 3.93; SD = .31; ICC = .936 [IC = .854-.981]), and participants Adherence (X = 4.90; SD = .29; ICC = .906 [IC = .783-.969]), evaluated by two independent observers present in each session of the programme, descriptive and Intraclass Correlation results were considered adequate. Structural changes were introduced in the intervention design and implementation methods, as well as the removal of items from questionnaires and evaluation forms. The obtained results were satisfactory, allowing changes to be made for further efficacy trials of the programme. Results are discussed taking cultural and contextual demands in Brazil into account.

Keywords: feasibility study, health promotion, positive psychology intervention, programme evaluation, retirees

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Authors: Zermina Q., Wasif Y., Naeem S., Urooj S., Sajid R. A.

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Land degradation, a leading environemtnal problem and a decrease in the quality of land has become a major global issue, caused by human activities. By land degradation, more than half of the world’s drylands are affected. The worldwide scope of main saline soils is approximately 955 M ha, whereas inferior salinization affected approximately 77 M ha. In irrigated areas, a total of 58% of these soils is found. As most of the vegetation types requires fertile soil for their growth and quality production, salinity causes serious problem to the production of these vegetation types and agriculture demands. This research aims to identify the salt affected areas in the selected part of Indus Delta, Sindh province, Pakistan. This particular mangroves dominating coastal belt is important to the local community for their crop growth. Object based image analysis approach has been adopted on Landsat TM imagery of year 2011 by incorporating different mathematical band ratios, thermal radiance and salinity index. Accuracy assessment of developed salinity landcover map was performed using Erdas Imagine Accuracy Assessment Utility. Rain factor was also considered before acquiring satellite imagery and conducting field survey, as wet soil can greatly affect the condition of saline soil of the area. Dry season considered best for the remote sensing based observation and monitoring of the saline soil. These areas were trained with the ground truth data w.r.t pH and electric condutivity of the soil samples. The results were obtained from the object based image analysis of Keti bunder and Kharo chan shows most of the region under low saline soil.Total salt affected soil was measured to be 46,581.7 ha in Keti Bunder, which represents 57.81 % of the total area of 80,566.49 ha. High Saline Area was about 7,944.68 ha (9.86%). Medium Saline Area was about 17,937.26 ha (22.26 %) and low Saline Area was about 20,699.77 ha (25.69%). Where as total salt affected soil was measured to be 52,821.87 ha in Kharo Chann, which represents 55.87 % of the total area of 94,543.54 ha. High Saline Area was about 5,486.55 ha (5.80 %). Medium Saline Area was about 13,354.72 ha (14.13 %) and low Saline Area was about 33980.61 ha (35.94 %). These results show that the area is low to medium saline in nature. Accuracy of the soil salinity map was found to be 83 % with the Kappa co-efficient of 0.77. From this research, it was evident that this area as a whole falls under the category of low to medium saline area and being close to coastal area, mangrove forest can flourish. As Mangroves are salt tolerant plant so this area is consider heaven for mangrove plantation. It would ultimately benefit both the local community and the environment. Increase in mangrove forest control the problem of soil salinity and prevent sea water to intrude more into coastal area. So deforestation of mangrove should be regularly monitored.

Keywords: indus delta, object based image analysis, soil salinity, thematic mapper

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Authors: Charlotte Entwistle, Ryan Boyd

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Recent developments in information retrieval techniques and natural language processing have allowed for greater exploration of psychological and social processes. Linguistic analysis methods for understanding behaviour have provided useful insights within the field of mental health. One area within mental health that has received little attention though, is borderline personality disorder (BPD). BPD is a common mental health disorder characterised by instability of interpersonal relationships, self-image and affect. It also manifests through maladaptive behaviours, such as impulsivity and self-harm. Examination of language patterns associated with BPD could allow for a greater understanding of the disorder and its links to maladaptive thoughts and behaviours. Language analysis methods could also be used in a predictive way, such as by identifying indicators of BPD or predicting maladaptive thoughts, emotions and behaviours. Additionally, associations that are uncovered between language and maladaptive thoughts and behaviours could then be applied at a more general level. This study explores linguistic characteristics of BPD, and their links to maladaptive thoughts and behaviours, through the analysis of social media data. Data were collected from a large corpus of posts from the publicly available social media platform Reddit, namely, from the ‘r/BPD’ subreddit whereby people identify as having BPD. Data were collected using the Python Reddit API Wrapper and included all users which had posted within the BPD subreddit. All posts were manually inspected to ensure that they were not posted by someone who clearly did not have BPD, such as people posting about a loved one with BPD. These users were then tracked across all other subreddits of which they had posted in and data from these subreddits were also collected. Additionally, data were collected from a random control group of Reddit users. Disorder-relevant behaviours, such as self-harming or aggression-related behaviours, outlined within Reddit posts were coded to by expert raters. All posts and comments were aggregated by user and split by subreddit. Language data were then analysed using the Linguistic Inquiry and Word Count (LIWC) 2015 software. LIWC is a text analysis program that identifies and categorises words based on linguistic and paralinguistic dimensions, psychological constructs and personal concern categories. Statistical analyses of linguistic features could then be conducted. Findings revealed distinct linguistic features associated with BPD, based on Reddit posts, which differentiated these users from a control group. Language patterns were also found to be associated with the occurrence of maladaptive thoughts and behaviours. Thus, this study demonstrates that there are indeed linguistic markers of BPD present on social media. It also implies that language could be predictive of maladaptive thoughts and behaviours associated with BPD. These findings are of importance as they suggest potential for clinical interventions to be provided based on the language of people with BPD to try to reduce the likelihood of maladaptive thoughts and behaviours occurring. For example, by social media tracking or engaging people with BPD in expressive writing therapy. Overall, this study has provided a greater understanding of the disorder and how it manifests through language and behaviour.

Keywords: behaviour analysis, borderline personality disorder, natural language processing, social media data

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Authors: George Kassar, Phillip A. Cartwright

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Based on data collected from The Jones Learning Center (JLC), University of the Ozarks, Arkansas, U.S., this study explores the impact of inclusive classroom practices on neuro-diverse college students’ and their consequent academic performance having participated in integrative therapies designed to support students who are intellectually capable of obtaining a college degree, but who require support for learning challenges owing to disabilities, AD/HD, or ASD. The purpose of this study is two-fold. The first objective is to explore the general process, special techniques, and practices of the (JLC) inclusive program. The second objective is to identify and analyze the effectiveness of the processes, techniques, and practices in supporting the academic performance of enrolled college students with learning disabilities following integration into mainstream university learning. Integrity, transparency, and confidentiality are vital in the research. All questions were shared in advance and confirmed by the concerned management at the JLC. While administering the questionnaire as well as conducted the interviews, the purpose of the study, its scope, aims, and objectives were clearly explained to all participants prior starting the questionnaire / interview. Confidentiality of all participants assured and guaranteed by using encrypted identification of individuals, thus limiting access to data to only the researcher, and storing data in a secure location. Respondents were also informed that their participation in this research is voluntary, and they may withdraw from it at any time prior to submission if they wish. Ethical consent was obtained from the participants before proceeding with videorecording of the interviews. This research uses a mixed methods approach. The research design involves collecting, analyzing, and “mixing” quantitative and qualitative methods and data to enable a research inquiry. The research process is organized based on a five-pillar approach. The first three pillars are focused on testing the first hypothesis (H1) directed toward determining the extent to the academic performance of JLC students did improve after involvement with comprehensive JLC special program. The other two pillars relate to the second hypothesis (H2), which is directed toward determining the extent to which collective and applied knowledge at JLC is distinctive from typical practices in the field. The data collected for research were obtained from three sources: 1) a set of secondary data in the form of Grade Point Average (GPA) received from the registrar, 2) a set of primary data collected throughout structured questionnaire administered to students and alumni at JLC, and 3) another set of primary data collected throughout interviews conducted with staff and educators at JLC. The significance of this study is two folds. First, it validates the effectiveness of the special program at JLC for college-level students who learn differently. Second, it identifies the distinctiveness of the mix of techniques, methods, and practices, including the special individualized and personalized one-on-one approach at JLC.

Keywords: education, neuro-diverse students, program effectiveness, Jones learning center

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Authors: Ming-Hsiang Shih, Wen-Pei Sung, Shih-Heng Tung

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The purposes of hydraulic gate are to maintain the functions of storing and draining water. It bears long-term hydraulic pressure and earthquake force and is very important for reservoir and waterpower plant. The high tensile strength of steel plate is used as constructional material of hydraulic gate. The cracks and rusts, induced by the defects of material, bad construction and seismic excitation and under water respectively, thus, the mechanics phenomena of gate with crack are probing into the cause of stress concentration, induced high crack increase rate, affect the safety and usage of hydroelectric power plant. Stress distribution analysis is a very important and essential surveying technique to analyze bi-material and singular point problems. The finite difference infinitely small element method has been demonstrated, suitable for analyzing the buckling phenomena of welding seam and steel plate with crack. Especially, this method can easily analyze the singularity of kink crack. Nevertheless, the construction form and deformation shape of some gates are three-dimensional system. Therefore, the three-dimensional Digital Image Correlation (DIC) has been developed and applied to analyze the strain variation of steel plate with crack at weld joint. The proposed Digital image correlation (DIC) technique is an only non-contact method for measuring the variation of test object. According to rapid development of digital camera, the cost of this digital image correlation technique has been reduced. Otherwise, this DIC method provides with the advantages of widely practical application of indoor test and field test without the restriction on the size of test object. Thus, the research purpose of this research is to develop and apply this technique to monitor mechanics crack variations of weld steel hydraulic gate and its conformation under action of loading. The imagines can be picked from real time monitoring process to analyze the strain change of each loading stage. The proposed 3-Dimensional digital image correlation method, developed in the study, is applied to analyze the post-buckling phenomenon and buckling tendency of welded steel plate with crack. Then, the stress intensity of 3-dimensional analysis of different materials and enhanced materials in steel plate has been analyzed in this paper. The test results show that this proposed three-dimensional DIC method can precisely detect the crack variation of welded steel plate under different loading stages. Especially, this proposed DIC method can detect and identify the crack position and the other flaws of the welded steel plate that the traditional test methods hardly detect these kind phenomena. Therefore, this proposed three-dimensional DIC method can apply to observe the mechanics phenomena of composite materials subjected to loading and operating.

Keywords: welded steel plate, crack variation, three-dimensional digital image correlation (DIC), crack stel plate

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Authors: Roni Ramon-Gonen, Amir Dori, Shahar Shelly

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Background and objectives: Healthcare professionals produce abundant textual information in their daily clinical practice. The extraction of insights from all the gathered information, mainly unstructured and lacking in normalization, is one of the major challenges in computational medicine. In this respect, text mining assembles different techniques to derive valuable insights from unstructured textual data, so it has led to being especially relevant in Medicine. Neurological patient’s history allows the clinician to define the patient’s symptoms and along with the result of the nerve conduction study (NCS) and electromyography (EMG) test, assists in formulating a differential diagnosis. Past medical history (PMH) helps to direct the latter. In this study, we aimed to identify relevant PMH, understand which PMHs are common among patients in the referral cohort and documented by the medical staff, and examine the differences by sex and age in a large cohort based on textual format notes. Methods: We retrospectively identified all patients with abnormal NCS between May 2016 to February 2022. Age, gender, and all NCS attributes reports were recorded, including the summary text. All patients’ histories were extracted from the text report by a query. Basic text cleansing and data preparation were performed, as well as lemmatization. Very popular words (like ‘left’ and ‘right’) were deleted. Several words were replaced with their abbreviations. A bag of words approach was used to perform the analyses. Different visualizations which are common in text analysis, were created to easily grasp the results. Results: We identified 5282 unique patients. Three thousand and five (57%) patients had documented PMH. Of which 60.4% (n=1817) were males. The total median age was 62 years (range 0.12 – 97.2 years), and the majority of patients (83%) presented after the age of forty years. The top two documented medical histories were diabetes mellitus (DM) and surgery. DM was observed in 16.3% of the patients, and surgery at 15.4%. Other frequent patient histories (among the top 20) were fracture, cancer (ca), motor vehicle accident (MVA), leg, lumbar, discopathy, back and carpal tunnel release (CTR). When separating the data by sex, we can see that DM and MVA are more frequent among males, while cancer and CTR are less frequent. On the other hand, the top medical history in females was surgery and, after that, DM. Other frequent histories among females are breast cancer, fractures, and CTR. In the younger population (ages 18 to 26), the frequent PMH were surgery, fractures, trauma, and MVA. Discussion: By applying text mining approaches to unstructured data, we were able to better understand which medical histories are more relevant in these circumstances and, in addition, gain additional insights regarding sex and age differences. These insights might help to collect epidemiological demographical data as well as raise new hypotheses. One limitation of this work is that each clinician might use different words or abbreviations to describe the same condition, and therefore using a coding system can be beneficial.

Keywords: abnormal studies, healthcare analytics, medical history, nerve conduction studies, text mining, textual analysis

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Authors: Venencia Albert, Arulselvi Subramanian, Hara Prasad Pati, Asok K. Mukhophadhyay

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Acute traumatic coagulopathy in an endogenous dysregulation of the intrinsic coagulation system in response to the injury, associated with three-fold risk of poor outcome, and is more amenable to corrective interventions, subsequent to early identification and management. Multiple definitions for stratification of the patients' risk for early acute coagulopathy have been proposed, with considerable variations in the defining criteria, including several trauma-scoring systems based on prehospital data. We aimed to develop a clinically relevant definition for acute coagulopathy of trauma based on conventional coagulation assays and to assess its efficacy in comparison to recently established prehospital prediction models. Methodology: Retrospective data of all trauma patients (n = 490) presented to our level I trauma center, in 2014, was extracted. Receiver operating characteristic curve analysis was done to establish cut-offs for conventional coagulation assays for identification of patients with acute traumatic coagulopathy was done. Prospectively data of (n = 100) adult trauma patients was collected and cohort was stratified by the established definition and classified as "coagulopathic" or "non-coagulopathic" and correlated with the Prediction of acute coagulopathy of trauma score and Trauma-Induced Coagulopathy Clinical Score for identifying trauma coagulopathy and subsequent risk for mortality. Results: Data of 490 trauma patients (average age 31.85±9.04; 86.7% males) was extracted. 53.3% had head injury, 26.6% had fractures, 7.5% had chest and abdominal injury. Acute traumatic coagulopathy was defined as international normalized ratio ≥ 1.19; prothrombin time ≥ 15.5 s; activated partial thromboplastin time ≥ 29 s. Of the 100 adult trauma patients (average age 36.5±14.2; 94% males), 63% had early coagulopathy based on our conventional coagulation assay definition. Overall prediction of acute coagulopathy of trauma score was 118.7±58.5 and trauma-induced coagulopathy clinical score was 3(0-8). Both the scores were higher in coagulopathic than non-coagulopathic patients (prediction of acute coagulopathy of trauma score 123.2±8.3 vs. 110.9±6.8, p-value = 0.31; trauma-induced coagulopathy clinical score 4(3-8) vs. 3(0-8), p-value = 0.89), but not statistically significant. Overall mortality was 41%. Mortality rate was significantly higher in coagulopathic than non-coagulopathic patients (75.5% vs. 54.2%, p-value = 0.04). High prediction of acute coagulopathy of trauma score also significantly associated with mortality (134.2±9.95 vs. 107.8±6.82, p-value = 0.02), whereas trauma-induced coagulopathy clinical score did not vary be survivors and non-survivors. Conclusion: Early coagulopathy was seen in 63% of trauma patients, which was significantly associated with mortality. Acute traumatic coagulopathy defined by conventional coagulation assays (international normalized ratio ≥ 1.19; prothrombin time ≥ 15.5 s; activated partial thromboplastin time ≥ 29 s) demonstrated good ability to identify coagulopathy and subsequent mortality, in comparison to the prehospital parameter-based scoring systems. Prediction of acute coagulopathy of trauma score may be more suited for predicting mortality rather than early coagulopathy. In emergency trauma situations, where immediate corrective measures need to be taken, complex multivariable scoring algorithms may cause delay, whereas coagulation parameters and conventional coagulation tests will give highly specific results.

Keywords: trauma, coagulopathy, prediction, model

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Authors: Kirti Hira, A. Sajeli Begum, S. Mahibalan, Poorna Chandra Rao

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Introduction: Cancer is one of the leading causes of death worldwide. Although existing therapy effectively kills cancer cells, they do affect normal growing cells leading to many undesirable side effects. Hence there is need to develop effective as well as safe drug molecules to combat cancer, which is possible through phyto-research. The currently available plant-derived blockbuster drugs are the example for this. In view of this, an investigation was done to identify cytotoxic lead molecules from Hedyotis umbellata (Family Rubiaceae), a widely distributed weed in India. Materials and Methods: The methanolic extract of the whole plant of H. umbellata (MHU), prepared through Soxhlet extraction method was further fractionated with diethyl ether and n-butanol, successively. MHU, ether fraction (EMHU) and butanol fraction (BMHU) were lyophilized and were tested for the cytotoxic effect using 3-(4,5-Dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay against non-small cell lung cancer (NSCLC) A549 cell lines. The potentially active EMHU was subjected to chromatographic purification using normal-phase silica columns, in order to isolate the responsible bioactive compounds. The isolated pure compounds were tested for their cytotoxic effect by MTT assay against A549 cells. Compound-3, which was found to be most active, was characterized using IR, 1H- and 13C-NMR and MS analysis. The study was further extended to decipher the mechanism of action of cytotoxicity of compound-3 against A549 cells through various in vitro cellular models. Cell cycle analysis was done using flow cytometry following PI (Propidium Iodide) staining. Protein analysis was done using Western blot technique. Results: Among MHU, EMHU, and BMHU, the non-polar fraction EMHU demonstrated a significant dose-dependent cytotoxic effect with IC50 of 67.7μg/ml. Chromatography of EMHU yielded seven compounds. MTT assay of isolated compounds explored compound-3 as potentially active one, which inhibited the growth of A549 cells with IC50value of 14.2μM. Further, compound-3 was identified as cedrelopsin, a coumarin derivative having molecular weight of 260. Results of in vitro mechanistic studies explained that cedrelopsin induced cell cycle arrest at G2/M phase and down-regulated the expression of G2/M regulatory proteins such as cyclin B1, cdc2, and cdc25C, dose dependently. This is the first report that explores the cytotoxic mechanism of cedrelopsin. Conclusion: Thus a potential small lead molecule, cedrelopsin isolated from H. umbellata, showing antiproliferative effect mediated by G2/M arrest in A549 cells was discovered. The effect of cedrelopsin against other cancer cell lines followed by in vivo studies can be performed in future to develop a new drug candidate.

Keywords: A549, cedrelopsin, G2/M phase, Hedyotis umbellata

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Authors: O. R. Razanakoto, L. Temple

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Living in a least developed country, the Malagasy society has a weak capacity to internalize progress, including health concerns. Since the arrival in the fifteenth century of Arabic script, called Sorabe, that was mainly dedicated to the aristocracy, until the colonial era beginning at the end of the nineteenth century and that has popularized the current usual script of the occidental civilization, the upcoming manuscripts that deal with apparent scientific or at least academic issue have been slowly established. So that, the Malagasy communities’ way of life is not well documented yet to allow a precise understanding of the major concerns, reason, and purpose of the existence of the farmers that compose them. A question arises, according to literature, how does Malagasy community that is dominated by agrarian society conceive the conservation of its wellbeing? This study aims to emphasize the scope and the limits of the « One Health » concept or of the Health Integrated Approach (HIA) that evolves at global scale, with regard to the specific context of local Malagasy smallholder farms. It is expected to identify how this society represents linked risks and the mechanisms between human health, animal health, plant health, and ecosystem health within the last 100 years. To do so, the framework to conduct systematic review for agricultural research has been deployed to access available literature. This task has been coupled with the reading of articles that are not indexed by online scientific search engine but that mention part of a history of agriculture and of farmers in Madagascar. This literature review has informed the interactions between human illnesses and those affecting animals and plants (breeded or wild) with any unexpected event (ecological or economic) that has modified the equilibrium of the ecosystem, or that has disturbed the livelihoods of agrarian communities. Besides, drivers that may either accentuate or attenuate the devasting effects of these illnesses and changes were revealed. The study has established that the reasons of human worries are not only physiological. Among the factors that regulate global health, food system and contemporary medicine have helped to the improvement of life expectancy from 55 to 63 years in Madagascar during the last 50 years. However, threats to global health are still occurring. New human or animal illnesses and livestock / plant pathology or enemies may also appear, whereas ancient illnesses that are supposed to have disappeared may be back. This study has highlighted how much important are the risks associated to the impact of unmanaged externalities that weaken community’s life. Many risks, and also solutions, come from abroad and have long term effects even though those happen as punctual event. Thus, a constructivist strategy is suggested to the « One Health » global concept throughout the record of local facts. This approach should facilitate the exploration of methodological pathways and the identification of relevant indicators for research related to HIA.

Keywords: agrarian system, health integrated approach, history, madagascar, resilience, risk

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Authors: Anatoliy A. Alabugin, Nikolay K. Topuzov, Sergei V. Aliukov

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It is well known, that while we do a quantitative evaluation of the quality control of some economic processes (in particular, resource saving) with help innovation factors, there are three groups of problems: high uncertainty of indicators of the quality management, their considerable ambiguity, and high costs to provide a large-scale research. These problems are defined by the use of contradictory objectives of enhancing of the quality control in accordance with innovation factors and preservation of economic stability of the enterprise. The most acutely, such factors are felt in the countries lagging behind developed economies of the world according to criteria of innovativeness and effectiveness of management of the resource saving. In our opinion, the following two methods for reconciling of the above-mentioned objectives and reducing of conflictness of the problems are to solve this task most effectively: 1) the use of paradigms and concepts of evolutionary improvement of quality of resource-saving management in the cycle "from the project of an innovative product (technology) - to its commercialization and update parameters of customer value"; 2) the application of the so-called integrative-cyclical approach which consistent with complexity and type of the concept, to studies allowing to get quantitative assessment of the stages of achieving of the consistency of these objectives (from baseline of imbalance, their compromise to achievement of positive synergies). For implementation, the following mathematical tools are included in the integrative-cyclical approach: index-factor analysis (to identify the most relevant factors); regression analysis of relationship between the quality control and the factors; the use of results of the analysis in the model of fuzzy sets (to adjust the feature space); method of non-parametric statistics (for a decision on the completion or repetition of the cycle in the approach in depending on the focus and the closeness of the connection of indicator ranks of disbalance of purposes). The repetition is performed after partial substitution of technical and technological factors ("hard") by management factors ("soft") in accordance with our proposed methodology. Testing of the proposed approach has shown that in comparison with the world practice there are opportunities to improve the quality of resource-saving management using innovation factors. We believe that the implementation of this promising research, to provide consistent management decisions for reducing the severity of the above-mentioned contradictions and increasing the validity of the choice of resource-development strategies in terms of parameters of quality management and sustainability of enterprise, is perspective. Our existing experience in the field of quality resource-saving management and the achieved level of scientific competence of the authors allow us to hope that the use of the integrative-cyclical approach to the study and evaluation of the resulting and factor indicators will help raise the level of resource-saving characteristics up to the value existing in the developed economies of post-industrial type.

Keywords: integrative-cyclical approach, quality control, evaluation, innovation factors. economic sustainability, innovation cycle of management, disbalance of goals of development

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Authors: Ripudaman S. Minhas, Pardeep K. Benipal, Aisha K. Yousafzai

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Background: Children of refugee or asylum-seeking background have multiple, complex needs (e.g. trauma, mental health concerns, separation, relocation, poverty, etc.) that places them at an increased risk for developing learning problems. Families encounter challenges accessing support during resettlement, preventing children from achieving their full developmental potential. There are very few studies in literature that examine the unique parenting challenges refugee families’ face. Providing appropriate support services and educational resources that address these distinctive concerns of refugee parents, will alleviate these challenges allowing for a better developmental outcome for children. Objective: To identify the characteristics of effective parenting interventions that address the unique needs of refugee families. Methods: English-language articles published from 1997 onwards were included if they described or evaluated programmes or interventions for parents of refugee or asylum-seeking background, globally. Data were extracted and analyzed according to Arksey and O’Malley’s descriptive analysis model for scoping reviews. Results: Seven studies met criteria and were included, primarily studying families settled in high-income countries. Refugee parents identified parenting to be a major concern, citing they experienced: alienation/unwelcoming services, language barriers, and lack of familiarity with school and early years services. Services that focused on building the resilience of parents, parent education, or provided services in the family’s native language, and offered families safe spaces to promote parent-child interactions were most successful. Home-visit and family-centered programs showed particular success, minimizing barriers such as transportation and inflexible work schedules, while allowing caregivers to receive feedback from facilitators. The vast majority of studies evaluated programs implementing existing curricula and frameworks. Interventions were designed in a prescriptive manner, without direct participation by family members and not directly addressing accessibility barriers. The studies also did not employ evaluation measures of parenting practices or the caregiving environment, or child development outcomes, primarily focusing on parental perceptions. Conclusion: There is scarce literature describing parenting interventions for refugee families. Successful interventions focused on building parenting resilience and capacity in their native language. To date, there are no studies that employ a participatory approach to program design to tailor content or accessibility, and few that employ parenting, developmental, behavioural, or environmental outcome measures.

Keywords: asylum-seekers, developmental pediatrics, parenting interventions, refugee families

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Authors: Virginia Vettori, Chiara Lorini, Vieri Lastrucci, Giulia Di Pisa, Alessia De Blasi, Sara Giuggioli, Guglielmo Bonaccorsi

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The design of the Nutrition Literacy Assessment Instrument (NLit) responds to the need to provide a tool to adequately assess the construct of nutrition literacy (NL), which is strictly connected to the quality of the diet and nutritional health status. The NLit was originally developed and validated in the US context, and it was recently validated for Italian people too (NLit-IT), involving a sample of N = 74 adults. The results of the cross-cultural adaptation of the tool confirmed its validity since it was established that the level of NL contributed to predicting the level of adherence to the Mediterranean Diet (convergent validity). Additionally, results obtained proved that Internal Consistency and reliability of the NLit-IT were good (Cronbach’s alpha (ρT) = 0.78; 95% CI, 0.69–0.84; Intraclass Correlation Coefficient (ICC) = 0.68, 95% CI, 0.46–0.85). However, the Subscale 3 of the NLit-IT “Household Food Measurement” showed lower values of ρT and ICC (ρT = 0.27; 95% CI, 0.1–0.55; ICC = 0.19, 95% CI, 0.01–0.63) than the entire instrument. Subscale 3 includes nine items which are constituted by written questions and the corresponding pictures of the meals. In particular, items 2, 3, and 8 of Subscale 3 had the lowest level of correct answers. The purpose of the present study was to identify the factors that influenced the Internal Consistency and reliability of Subscale 3 of NLit-IT using the methodology of a focus group. A panel of seven experts was formed, involving professionals in the field of public health nutrition, dietetics, and health promotion and all of them were trained on the concepts of nutrition literacy and food appearance. A member of the group drove the discussion, which was oriented in the identification of the reasons for the low levels of reliability and Internal Consistency. The members of the group discussed the level of comprehension of the items and how they could be readapted. From the discussion, it emerges that the written questions were clear and easy to understand, but it was observed that the representations of the meal needed to be improved. Firstly, it has been decided to introduce a fork or a spoon as a reference dimension to better understand the dimension of the food portion (items 1, 4 and 8). Additionally, the flat plate of items 3 and 5 should be substituted with a soup plate because, in the Italian national context, it is common to eat pasta or rice on this kind of plate. Secondly, specific measures should be considered for some kind of foods such as the brick of yogurt instead of a cup of yogurt (items 1 and 4). Lastly, it has been decided to redo the photos of the meals basing on professional photographic techniques. In conclusion, we noted that the graphical representation of the items strictly influenced the level of participants’ comprehension of the questions; moreover, the research group agreed that the level of knowledge about nutrition and food portion size is low in the general population.

Keywords: nutritional literacy, cross cultural adaptation, misinformation, food design

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Authors: Jarrod Haar, David Brougham, Azka Ghafoor

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Māori are the indigenous people of Aotearoa (New Zealand) and have a unique perspective called Te Ao Māori (the Māori worldview) and important cultural values around utu (reciprocation), collectivism, long-term orientation, and whanaungatanga (networking, relationships). The present research conducts two studies to better understand how Māori businesses might have similarities and differences to New Zealand businesses. In study 1, we conducted 50 interviews with 25 Māori business owners and 25 New Zealand (non-Māori) owners. For the indigenous population, we used a kaupapa Māori research approach using Māori protocols. This ensured the research is culturally safe. Interviews were conducted around semi-structured questions tapping into the existing business challenges, the role of innovation, and business values and approaches. Transcripts were analyzed using interpretative phenomenological analytic techniques. We identified several themes shared across all business owners: (1) the critical challenge around staff attraction and retention; (2) cost pressures including inflation; (3) and a focus on human resource (HR) practices to address issues including retention. Amongst the Māori businesses, the analysis also identified (4) a unique cultural approach to business relationships. Specifically, amongst the indigenous businesses we find a strong Te Ao Māori perspective amongst Māori business towards innovation. Analysis within this group only identified, within the following sub-themes: (a) whanaungatanga, around the development of strong relationships as a way to aid recruitment and retention, and business fluctuations; (b) mātauranga (knowledge) whereby Māori businesses seek to access advanced knowledge via universities; (c) taking a long-term orientation to business relationships – including with universities. The findings suggest people practices might be a way that firms address workforce retention issues, and we also acknowledge that Māori businesses might also leverage cultural practices to achieve better gains. Thus, in study 2, we survey 606 New Zealand private sector firms including 85 who self-identify as Māori Firms. We test the benefits of high-performance work-systems (HPWS), which represent bundle of human-resource practices designed to bolster workforce productivity through enhancing knowledge, skills, abilities, and commitment of the workforce. We test these on workforce retention and include Māori firm status and cultural capital (reflecting workforce knowledge around Māori cultural values) as moderators. Overall, we find all firms achieve superior workforce retention when they have high levels of HPWS, but Māori firms with high cultural capital are better able to leverage these HR practices to achieve superior workforce retention. In summary, the present study highlights how indigenous businesses in New Zealand might achieve superior performance by leveraging their unique cultural values. The study provides unique insights into established literatures around retention and HR practices and highlights the lessons around indigenous cultural values that appear to aid businesses.

Keywords: Māori business, cultural values, employee retention, human resource practices

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Authors: Roberta Martino, Viviana Ventre

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Every day we face choices whose consequences are deferred in time. These types of choices are the intertemporal choices and play an important role in the social, economic, and financial world. The Discounted Utility Model is the mathematical model of reference to calculate the utility of intertemporal prospects. The discount rate is the main element of the model as it describes how the individual perceives the indeterminacy of subsequent periods. Empirical evidence has shown a discrepancy between the behavior expected from the predictions of the model and the effective choices made from the decision makers. In particular, the term temporal inconsistency indicates those choices that do not remain optimal with the passage of time. This phenomenon has been described with hyperbolic models of the discount rate which, unlike the linear or exponential nature assumed by the discounted utility model, is not constant over time. This paper explores the problem of inconsistency by tracing the decision-making process through the concept of impatience. The degree of impatience and the degree of decrease of impatience are two parameters that allow to quantify the weight of emotional factors and cognitive limitations during the evaluation and selection of alternatives. In fact, although the theory assumes perfectly rational decision makers, behavioral finance and cognitive psychology have made it possible to understand that distortions in the decision-making process and emotional influence have an inevitable impact on the decision-making process. The degree to which impatience is diminished is the focus of the first part of the study. By comparing consistent and inconsistent preferences over time, it was possible to verify that some anomalies in the discounted utility model are a result of the combination of cognitive bias and emotional factors. In particular: the delay effect and the interval effect are compared through the concept of misperception of time; starting from psychological considerations, a criterion is proposed to identify the causes of the magnitude effect that considers the differences in outcomes rather than their ratio; the sign effect is analyzed by integrating in the evaluation of prospects with negative outcomes the psychological aspects of loss aversion provided by Prospect Theory. An experiment implemented confirms three findings: the greatest variation in the degree of decrease in impatience corresponds to shorter intervals close to the present; the greatest variation in the degree of impatience occurs for outcomes of lower magnitude; the variation in the degree of impatience is greatest for negative outcomes. The experimental phase was implemented with the construction of the hyperbolic factor through the administration of questionnaires constructed for each anomaly. This work formalizes the underlying causes of the discrepancy between the discounted utility model and the empirical evidence of preference reversal.

Keywords: decreasing impatience, discount utility model, hyperbolic discount, hyperbolic factor, impatience

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Authors: Rochelle Daley, Eric Garraway, Catherine Murphy

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Crime is a major problem in Jamaica as well as the high number of unsolved violent crimes. The introduction of forensic entomology in criminal investigations has the potential to decrease the number of unsolved violent crimes through the estimation of PMI (post-mortem interval) or time since death. Though it has great potential, forensic entomology requires data from insects specific to a geographical location to be credibly applied in legal investigations. It is a relatively new area of study in the Caribbean, with multiple pioneer research opportunities. Of critical importance in forensic entomology is the ability to identify the species of interest. Larvae are commonly collected at crime scenes and a means of rapid identification is crucial. Moreover, a low-cost method is critical in countries with limited budget available for crime fighting. Sarcophagids are one of the most important colonisers of a carcass however, they are difficult to distinguish using morphology due to their similarities, however, there is a lack of research on the larvae of this family. This research contributes to that, having identified the larvae of three species from the family Sarcophagidae: Peckia nicasia, Peckia chrysostoma and Blaesoxipha plinthopyga; important agents in flesh decomposition. Adults of Sarcophidae are also difficult to differentiate, often requiring study of the genitalia; the use of larvae in species identification is important in such cases. Adult Sarcophagids were attracted using bottle traps baited with pig liver. These adults larviposited and the larvae were collected and colonises (generation 2 and 3) reared at room temperature for morphological work (n=50). The posterior ends of the larvae from segments 9 or 10 were removed and mounted posterior end upwards to allow study using a light microscope at magnification X200 (posterior cavity and intersegmental spine bands) and X640 (anterior and posterior spiracle). The remaining sections of the larvae were cleared in 10 % KOH and the cephalopharyngeal skeleton dissected out and measured at different points. The cephalopharyngeal skeletons show observable differences in the shapes and sizes of the mouth hooks as well as the length of the ventral cornua. The most notable difference between species is in the general shape of the anal segments and the shape of the posterior spiracles. Intersegmental spine bands of these larvae become less pigmented and visible as the larvae change instars. Spine bands along with anterior spiracle are not recommended as features for species distinction. Larvae can potentially be used to distinguish Sarcophagids to the level of species, with observable differences in the anal segments and the cephalopharyngeal skeletons. However, this method of identification should be tested by comparing these morphological features with other Jamaican Sarcophagids to further support this conclusion.

Keywords: 3rd instar larval morphology, forensic entomology, Jamaica, Sarcophagidae

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Authors: Catarina Belchior, Catarina Martins, Sara Mendes, Ana Rita S. Valente, Elsa Marta Soares

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Introduction: The negative feelings and attitudes that a person who stutters can develop are extremely relevant when considering assessment and intervention in Speech and Language Therapy. This relates to the fact that the person who stutters can experience feelings such as shame, fear and negative beliefs when communicating. Considering the complexity and importance of integrating diverse aspects in stuttering intervention, it is central to identify those emotions as early as possible. Therefore, this research aimed to achieve the translation, adaptation to European Portuguese and to analyze the content validation of the Preschooler Awareness Stuttering Survey (Abbiati, Guitar & Hutchins, 2015), an instrument that allows the assessment of the impact of stuttering on preschool children who stutter considering feelings and attitudes. Methodology: Cross-sectional descriptive qualitative research. The following methodological procedures were followed: translation, back-translation, panel of experts and pilot study. This abstract describes the results of the first three phases of this process. The translation was accomplished by two Speech Language Therapists (SLT). Both professionals have more than five years of experience and are users of English language. One of them has a broad experience in the field of stuttering. Back-translation was conducted by two bilingual individuals without experience in health or any knowledge about the instrument. The panel of experts was composed by 3 different SLT, experts in the field of stuttering. Results and Discussion: In the translation and back-translation process it was possible to verify differences in semantic and idiomatic equivalences of several concepts and expressions, as well as the need to include new information to enhance the understanding of the application of the instrument. The meeting between the two translators and the researchers allowed the achievement of a consensus version that was used in back-translation. Considering adaptation and content validation, the main change made by the experts was the conceptual equivalence of the questions and answers of the instrument's sheets. Considering that in the translated consensus version the questions began with various nouns such as 'is' or 'the cow' and that the answers did not contain the adverb 'much' as in the original instrument, the panel agreed that it would be more appropriate if the questions all started with 'how' and that all the answers should present the adverb 'much'. This decision was made to ensure that the translate instrument would be similar to the original and so that the results obtained could be comparable between the original and the translated instrument. There was also elaborated one semantic equivalence between concepts. The panel of experts found that all other items and specificities of the instrument were adequate, concluding the adequacy of the instrument considering its objectives and its intended target population. Conclusion: This research aspires to diversify the existing validated resources in this scope, adding a new instrument that allows the assessment of preschool children who stutter. Consequently, it is hoped that this instrument will provide a real and reliable assessment that can lead to an appropriate therapeutic intervention according to the characteristics and needs of each child.

Keywords: stuttering, assessment, feelings and attitudes, speech language therapy

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Authors: Fayez Hanna, Viet Tran

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A 20 years old lady- primigravida 6 weeks pregnant with unremarkable past history, presented to the emergency department at the Royal Hobart Hospital, Tasmania, Australia, with hyperemesis gravidarum associated with, dehydration and complicated with hematemesis and chest pain resistant. Accordingly, we conducted laboratory investigations which revealed: FBC: WBC 23.9, unremarkable U&E, LFT, lipase and her VBG showed a pH 7.4, pCo2 36.7, cK+ 3.2, cNa+ 142. The decision was made to do a chest X-ray (CXR) after explaining the risks/benefit of performing radiographic investigations during pregnancy and considering the patient's plan for the termination of the pregnancy as she was not ready for motherhood for shared decision-making and consent to look for pneumoperitoneum to suggest perforated viscus that might cause the hematemesis. However, the CXR showed pneumomediastinum but no evidence of pneumoperitoneum or pneumothorax. Consequently, a decision was made to proceed with CT oesophagography with imaging pre and post oral contrast administration to identify a potential oesophageal tear since it could not be excluded using a plain film of the CXR. The CT oesophagography could not find a leak for the administered oral contrast and thus, no oesophageal tear could be confirmed but could not exclude the Mallory-Weiss tear (lower oesophageal tear). Further, the CT oesophagography showed an extensive pneumomediastinum that could not be confirmed to be pulmonary in origin noting the presence of bilateral pulmonary interstitial emphysema and pneumothorax in the apex of the right lung that was small. The patient was admitted to the Emergency Department Inpatient Unit for monitoring, supportive therapy, and symptomatic management. Her hyperemesis was well controlled with ondansetron 8mg IV, metoclopramide 10mg IV, doxylamine 25mg PO, pyridoxine 25mg PO, esomeprazole 40mg IV and oxycodone 5mg PO was given for pain control and 2 litter of IV fluid. The patient was stabilized after 24 hours and discharged home on ondansetron 8mg every 8 hours whereas the patient had a plan for medical termination of pregnancy. Three weeks later, the patient represented with nausea and vomiting complicated by a frank hematemesis. Her observation chart showed HR 117- other vital signs were normal. Pathology showed WBC 14.3 with normal U&E and Hb. The patient was managed in the Emergency Department with the same previous regimen and was discharged home on same previous regimes. Five days later, she presented again with nausea, vomiting and hematemesis and was admitted under obstetrics and gynaecology for stabilization then discharged home with a plan for surgical termination of pregnancy after 3-days rather than the previously planned medical termination of pregnancy to avoid extension of potential oesophageal tear. The surgical termination and follow up period were uneventful. The case is considered rare as pneumomediastinum is a very rare complication of hyperemesis gravidarum where vomiting-induced barotrauma leads to a ruptured oesophagus and air leak into the mediastinum. However no rupture oesophagus in our case. Although the combination of pneumothorax and pneumomediastinum without oesophageal tear was reported only 8 times in the literature, but none of them was due to hyperemesis gravidarum.

Keywords: Pneumothorax, pneumomediastinum, hyperemesis gravidarum, pneumopericardium

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Authors: Heikki Ruohomaa, Vesa Salminen

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Regions are facing huge competition to attract companies, businesses, inhabitants, students, etc. This way to improve living and business environment, which is rapidly changing due to digitalization. On the other hand, from the industry's point of view, the availability of a skilled labor force and an innovative environment are crucial factors. In this context, qualified staff has been seen to utilize the opportunities of digitalization and respond to the needs of future skills. World Manufacturing Forum has stated in the year 2019- report that in next five years, 40% of workers have to change their core competencies. Through digital transformation, new technologies like cloud, mobile, big data, 5G- infrastructure, platform- technology, data- analysis, and social networks with increasing intelligence and automation, enterprises can capitalize on new opportunities and optimize existing operations to achieve significant business improvement. Digitalization will be an important part of the everyday life of citizens and present in the working day of the average citizen and employee in the future. For that reason, the education system and education programs on all levels of education from diaper age to doctorate have been directed to fulfill this ecosystem strategy. Goal: The Fourth Industrial Revolution will bring unprecedented change to societies, education organizations and business environments. This article aims to identify how education, education content, the way education has proceeded, and overall whole the education business is changing. Most important is how we should respond to this inevitable co- evolution. Methodology: The study aims to verify how the learning process is boosted by new digital content, new learning software and tools, and customer-oriented learning environments. The change of education programs and individual education modules can be supported by applied research projects. You can use them in making proof- of- the concept of new technology, new ways to teach and train, and through the experiences gathered change education content, way to educate and finally education business as a whole. Major findings: Applied research projects can prove the concept- phases on real environment field labs to test technology opportunities and new tools for training purposes. Customer-oriented applied research projects are also excellent for students to make assignments and use new knowledge and content and teachers to test new tools and create new ways to educate. New content and problem-based learning are used in future education modules. This article introduces some case study experiences on customer-oriented digital transformation projects and how gathered knowledge on new digital content and a new way to educate has influenced education. The case study is related to experiences of research projects, customer-oriented field labs/learning environments and education programs of Häme University of Applied Sciences.

Keywords: education process, digitalization content, digital tools for education, learning environments, transdisciplinary co-operation

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Authors: A. M. Andriano, M. Lombardi, A. Lopolito, M. Prosperi, A. Stasi, E. Iannuzzi

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In according to the scientific debate on the definition of Social Innovation (SI), the present paper identifies SI as new ideas (products, services, and models) that simultaneously meet social needs and create new social relationships or collaborations. This concept offers important tools to unravel the difficult condition for the agricultural sector in marginalized areas, characterized by the abandonment of activities, low level of farmer education, and low generational renewal, hampering new territorial strategies addressed at and integrated and sustainable development. Models of SI in agriculture, starting from bottom up approach or from the community, are considered to represent the driving force of an ecological and digital revolution. A system based on SI may be able to grasp and satisfy individual and social needs and to promote new forms of entrepreneurship. In this context, Vazapp ('Go Hoeing') is an emerging SI model in southern Italy that promotes solutions for satisfying needs of farmers and facilitates their relationships (creation of network). The Vazapp’s initiative, considered in this study, is the Contadinners ('Farmer’s dinners'), a dinner held at farmer’s house where stakeholders living in the surrounding area know each other and are able to build a network for possible future professional collaborations. The aim of the paper is to identify the evolution of farmers’ relationships, both quantitatively and qualitatively, because of the Contadinner’s initiative organized by Vazapp. To this end, the study adopts the Social Network Analysis (SNA) methodology by using UCINET (Version 6.667) software to analyze the relational structure. Data collection was realized through a questionnaire distributed to 387 participants in the twenty 'Contadinners', held from February 2016 to June 2018. The response rate to the survey was about 50% of farmers. The elaboration data was focused on different aspects, such as: a) the measurement of relational reciprocity among the farmers using the symmetrize method of answers; b) the measurement of the answer reliability using the dichotomize method; c) the description of evolution of social capital using the cohesion method; d) the clustering of the Contadinners' participants in followers and not-followers of Vazapp to evaluate its impact on the local social capital. The results concern the effectiveness of this initiative in generating trustworthy relationships within the rural area of southern Italy, typically affected by individualism and mistrust. The number of relationships represents the quantitative indicator to define the dimension of the network development; while the typologies of relationships (from simple friendship to formal collaborations, for branding new cooperation initiatives) represents the qualitative indicator that offers a diversified perspective of the network impact. From the analysis carried out, Vazapp’s initiative represents surely a virtuous SI model to catalyze the relationships within the rural areas and to develop entrepreneurship based on the real needs of the community.

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Authors: I. Derek Kaka’an, P. Smolianov, D. Koh Choon Lian, S. Dion, C. Schoen, J. Norberg

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This study was designed to examine mass participation and elite football performance in Nigeria with reference to advance international football management practices. Over 200 sources of literature on sport delivery systems were analyzed to construct a globally applicable model of elite football integrated with mass participation, comprising of the following three levels: macro- (socio-economic, cultural, legislative, and organizational), meso- (infrastructures, personnel, and services enabling sport programs) and micro-level (operations, processes, and methodologies for development of individual athletes). The model has received scholarly validation and showed to be a framework for program analysis that is not culturally bound. The Smolianov and Zakus model has been employed for further understanding of sport systems such as US soccer, US Rugby, swimming, tennis, and volleyball as well as Russian and Dutch swimming. A questionnaire was developed using the above-mentioned model. Survey questions were validated by 12 experts including academicians, executives from sport governing bodies, football coaches, and administrators. To identify best practices and determine areas for improvement of football in Nigeria, 120 coaches completed the questionnaire. Useful exemplars and possible improvements were further identified through semi-structured discussions with 10 Nigerian football administrators and experts. Finally, content analysis of Nigeria Football Federation’s website and organizational documentation was conducted. This paper focuses on the meso-level of Nigerian football delivery, particularly infrastructures, personnel, and services enabling sport programs. This includes training centers, competition systems, and intellectual services. Results identified remarkable achievements coupled with great potential to further develop football in different types of public and private organizations in Nigeria. These include: assimilating football competitions with other cultural and educational activities, providing favorable conditions for employees of all possible organizations to partake and help in managing football programs and events, providing football coaching integrated with counseling for prevention of antisocial conduct, and improving cooperation between football programs and organizations for peace-making and advancement of international relations, tourism, and socio-economic development. Accurate reporting of the sports programs from the media should be encouraged through staff training for better awareness of various events. The systematic integration of these meso-level practices into the balanced development of mass and high-performance football will contribute to international sport success as well as national health, education, and social harmony.

Keywords: football, high performance, mass participation, Nigeria, sport development

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Authors: Bianca Koroschetz, Emma Mäenpää

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The purpose of this paper is to study consumer practices and meanings of different antifouling methods in order to identify the main barriers for sustainable consumption of antifouling products in the Baltic Sea. The Baltic Sea is considered to be an important tourism area. More than 3.5 million leisure boaters use the sea for recreational boating. Most leisure boat owners use toxic antifouling paint to keep barnacles from attaching to the hull. Attached barnacles limit maneuverability and add drag which in turn increases fuel costs. Antifouling paint used to combat barnacles causes particular problems, as the use of these products continuously adds to the distribution of biocides in the coastal ecosystem and leads to the death of marine organisms. To keep the Baltic Sea as an attractive tourism area measures need to be undertaken to stop the pollution coming from toxic antifouling paints. The antifouling market contains a wide range of environment-friendly alternative products such as a brush wash for boats, hand scrubbing devices, hull covers and boat lifts. Unfortunately, not a lot of boat owners use these environment-friendly alternatives and instead prefer the use of the traditional toxic copper paints. We ask “Why is the unsustainable consumption of toxic paints still predominant when there is a big range of environment-friendly alternatives available? What are the barriers for sustainable consumption?” Environmental psychology has concentrated on developing models of human behavior, including the main factors that influence pro-environmental behavior. The main focus of these models was directed to the individual’s attitudes, principals, and beliefs. However, social practice theory emphasizes the importance to study practices, as they have a stronger explanatory power than attitude-behavior to explain unsustainable consumer behavior. Thus, the study focuses on describing the material, meaning and competence of antifouling practice in order to understand the social and cultural embeddedness of the practice. Phenomenological interviews were conducted with boat owners using antifouling products such as paints and alternative methods. This data collection was supplemented with participant observations in marinas. Preliminary results indicate that different factors such as costs, traditions, advertising, frequency of use, marinas and application of method impact on the consumption of antifouling products. The findings have shown that marinas have a big influence on the consumption of antifouling goods. Some marinas are very active in supporting the sustainable consumption of antifouling products as for example in Stockholm area several marinas subsidize costs for using environmental friendly alternatives or even forbid toxic paints. Furthermore the study has revealed that environmental friendly methods are very effective and do not have to be more expensive than painting with toxic paints. This study contributes to a broader understanding why the unsustainable consumption of toxic paints is still predominant when a big range of environment-friendly alternatives exist. Answers to this phenomenon will be gained by studying practices instead of attitudes offering a new perspective on environmental issues.

Keywords: antifouling paint, Baltic Sea, boat tourism, sustainable consumption

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Authors: R. B. B. Samantha Ramachandra, L. D. J. Upul Senarath, S. H. Padmal De Silva

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Dietary pattern largely differs over countries and even within a country, it shows cultural differences. The dietary pattern changes the energy consumption and micronutrient intake, directly affects the pregnancy outcome. The dietary diversity was used as an indirect measure to assess micronutrient adequacy for pregnant mothers in this study. The study was conducted as a baseline survey with the objective of designing an intervention to improve the dietary diversity of pregnant mothers in Sri Lanka. The survey was conducted in Kalutara district of Sri Lanka in 2015 among 769 pregnant mothers at different gestational ages. Dietary diversity questionnaire developed by Food and Agricultural Organization’s (FAO) Food and Nutrition technical Assistance (FANTA) II project, recommended for cross-country use with adaptations was used for data collection. Trained data collectors met pregnant mothers at field ante-natal clinic and questioned on last 24hr dietary recall with portion size and coded food items to identify the diversity. Pregnant mothers were identified from randomly selected 21 clusters of public health midwife areas. 81.5% mothers (n=627) in the sample had been registered at Public Health Midwife (PHM) before 8 weeks of gestation. 24.4% of mothers were with low starting BMI and 22.7% mothers were with high starting BMI. 47.6% (n=388) mothers had abstained from at least one food item during the pregnancy. The food group with the highest consumption was rice (98.4%) followed by sugar (89.9%). 76.1% mothers had consumed milk, 73% consumed fish and sea foods. Consumption of green leaves was 52% and Vit A rich foods consumed only by 49% mothers. Animal organs, flesh meat and egg all showed low prevalence as 4.7%, 21.6% and 20% respectively. Consumption of locally grown roots, nut, legumes all showed very low prevalence. Consumption of 6 or more food groups was considered as good dietary diversity (DD), 4 to 5 food groups as moderate diversity and 3 or less food groups as poor diversity by FAO FANTA II project. 42.1% mothers demonstrated good DD while another 42.1% recorded moderate diversity. Working mothers showed better DD (51.6%, n=82/159) compared to housewives in the sample (chi = 10.656a,. df=2, p=0.005). The good DD showed gradual improvement from 43.1% to 55.5% along the poorest to richest wealth index (Chi=48.045, df=8 and p=0.000). DD showed significant association with the ethnicity and Moors showed the lowest DD. DD showed no association with the home gardening even though where better diversity expected among those who have home gardening (p=0.548). Sri Lanka is a country where many food items can be grown in the garden and semi-urban setting have adequate space for gardening. Many Sri Lankan mothers do not add homegrown items in their meal. At the same time, their consumption of animal food shows low prevalence. The DD of most of the mothers being either moderate or low (58%) may result from inadequate micro nutrient intake during pregnancy. It is recommended that adding green leaves, locally grown vegetables, roots, nuts and legumes can help increasing the DD of Sri Lankan mothers at low cost.

Keywords: dietary diversity, pregnant mothers, micro-nutrient, food groups

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Authors: E. Wairimu Mwangi, Daniel Sarpong

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Background: Access to effective antiretroviral therapy in the United States has resulted in the rise in longevity in people living with HIV (PLHIV). Despite the progress, women living with HIV (WLWH) experience increasing rates of cardiometabolic disorders compared with their HIV-negative counterparts. Studies focusing on the predictors of metabolic disorders in this population have largely focused on the composite measure of metabolic syndrome (METs). This study seeks to identify the predictors of composite and individual METs factors in a nationally representative sample of WLWH. In particular, the study also examines the role of food security in predicting METs. Methods: The study comprised 1800 women, a subset of participants from the Women’s Interagency HIV Study (WIHS). The primary exposure variable, food security, was measured using the U.S. 10-item Household Food Security Survey Module. The outcome measures are the five metabolic syndrome indicators (elevated blood pressure [systolic BP > 130 mmHg and diastolic BP ≥ 85 mmHg], elevated fasting glucose [≥ 110 mg/dL], elevated fasting triglyceride [≥ 150 mg/dL], reduced HDL cholesterol [< 50 mg/dL], and waist circumference > 88 cm) and the composite measure - Metabolic Syndrome (METs) Status. Each metabolic syndrome indicator was coded one if yes and 0 otherwise. The values of the five indicators were summed, and participants with a total score of 3 or greater were classified as having metabolic syndrome. Participants classified as having metabolic syndrome were assigned a code of 1 and 0 otherwise for analysis. The covariates accounted for in this study fell into sociodemographic factors and behavioral and health characteristics. Results: The participants' mean (SD) age was 47.1 (9.1) years, with 71.4% Blacks and 10.9% Whites. About a third (33.1%) had less than a high school (HS) diploma, 60.4% were married, 32.8% were employed, and 53.7% were low-income. The prevalence of worst dietary diversity, low, moderate, and high food security were 24.1%, 26.6%, 17.0%, and 56.4%, respectively. The correlate profile of the five individual METs factors plus the composite measure of METs differ significantly, with METs based on HDL having the most correlates (Age, Education, Drinking Status, Low Income, Body Mass Index, and Health Perception). Additionally, metabolic syndrome based on waist circumference was the only metabolic factor where food security was significantly correlated (Food Security, Age, and Body Mass Index). Age was a significant predictor of all five individual METs factors plus the composite METs measure. Except for METs based on Fasting Triglycerides, body mass index (BMI) was a significant correlate of the various measures of metabolic syndrome. Conclusion: High-density Lipoprotein (HDL) cholesterol significantly correlated with most predictors. BMI was a significant predictor of all METs factors except Fasting Triglycerides. Food insecurity, the primary predictor, was only significantly associated with waist circumference.

Keywords: blood pressure, food insecurity, fasting glucose, fasting triglyceride, high-density lipoprotein, metabolic syndrome, waist circumference, women living with HIV

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Authors: Keith Diamond, Tracy Collier, Ciara Sterling, Ben Kraal

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The increased frequency and intensity of disaster events in the Asia-Pacific region is likely to require organisations to better understand how their initiatives, and the support they provide to their customers, intersect with other organisations aiming to support communities in achieving disaster resilience. While there is a growing awareness that disaster response and recovery rebuild programmes need to adapt to more integrated, community-led approaches, there is often a discrepancy between how programmes intend to work and how they are collectively experienced in the community, creating undesired effects on community resilience. Following Australia’s North Queensland Monsoon Disaster of 2019, this research set out to understand and evaluate how the service and support ecosystem impacted on the local community’s experience and influenced their ability to respond and recover. The purpose of this initiative was to identify actionable, cross-sector, people-centered improvements that support communities to recover and thrive when faced with disaster. The challenge arose as a group of organisations, including utility providers, banks, insurers, and community organisations, acknowledged that improving their own services would have limited impact on community wellbeing unless the other services people need are also improved and aligned. The research applied human-centred service design methods, typically applied to single products or services, to design a new way to understand a whole-of-community journey. Phase 1 of the research conducted deep contextual interviews with residents and small business owners impacted by the North Queensland Monsoon and qualitative data was analysed to produce community journey maps that detailed how individuals navigated essential services, such as accommodation, finance, health, and community. Phase 2 conducted interviews and focus groups with frontline workers who represented industries that provided essential services to assist the community. Data from Phase 1 and Phase 2 of the research was analysed and combined to generate a systems map that visualised the positive and negative impacts that occurred across the disaster response and recovery service ecosystem. Insights gained from the research has catalysed collective action to address future Australian disaster events. The case study outlines a transformative way for sectors and industries to rethink their corporate social responsibility activities towards a cross-sector partnership model that shares responsibility and approaches disaster response and recovery as a single service that can be designed to meet the needs of communities.

Keywords: corporate social responsibility, cross sector partnerships, disaster resilience, human-centred design, service design, systems change

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Authors: Oli Sophie Meredith, Jacquelyn Osborne, Sarah Verdon, Jane Frawley

Abstract:

PROJECT OVERVIEW AND BACKGROUND: Over one million Australians are affected by ADHD at an economic and social cost of over $20 billion per annum. Despite health outcomes being significantly worse compared with men, women have historically been overlooked in ADHD diagnosis and treatment. While research suggests physical activity and other non-prescription options can help with ADHD symptoms, the frontline response to ADHD remains expensive stimulant medications that can have adverse side effects. By interviewing women with ADHD, this research will examine women’s self-directed approaches to managing symptoms, including alternatives to prescription medications. It will investigate barriers and affordances to potentially helpful approaches and identify any concerning strategies pursued in lieu of diagnosis. SIGNIFICANCE AND INNOVATION: Despite the economic and societal impact of ADHD on women, research investigating how women manage their symptoms is scant. This project is significant because although women’s ADHD symptoms are markedly different to those of men, mainstream treatment has been based on the experiences of men. Further, it is thought that in developing nuanced coping strategies, women may have masked their symptoms. Thus, this project will highlight strategies which women deem effective in ‘thriving’ rather than just ‘hiding’. By investigating the health service use, self-care and physical activity of women with ADHD, this research aligns with a priority research areas as identified by the November 2023 senate ADHD inquiry report. APPROACH AND METHODS: Semi-structured interviews will be conducted with up to 20 women with ADHD. Interviews will be conducted in person and online to capture experience across rural and metropolitan Australia. Participants will be recruited in partnership with the peak representative body, ADHD Australia. The research will use an intersectional framework, and data will be analysed thematically. This project is led by an interdisciplinary and cross-institutional team of women with ADHD. Reflexive interviewing skills will be employed to help interviewees feel more comfortable disclosing their experiences, especially where they share common ground ENGAGEMENT, IMPACT AND BENEFIT: This research will benefit women with ADHD by increasing knowledge of strategies and alternative treatments to prescription medications, reducing the social and economic burden of ADHD on Australia and on individuals. It will also benefit women by identifying risks involved with some self-directed approaches in lieu of medical advice. The project has an accessible impact plan to directly benefit end-users, which includes the development of a podcast and a PDF resource translating findings. The resources will reach a wide audience through ADHD Australia’s extensive national networks. We will collaborate with Charles Sturt’s Accessibility and Inclusion Division of Safety, Security and Well-being to create a targeted resource for students with ADHD.

Keywords: ADHD, women's health, self-directed strategies, health service use, physical activity, public health

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Authors: Diego F. Carrillo-González, Milena Osorio, Natalia M. Cerro, Yasser Y. Lenis

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Introduction: mortality during the implantation and early embryonic development periods reach around 30% in different mammalian species. It has been described that progesterone (P4) and Arginine (Arg) play a beneficial role in establishing and maintaining early pregnancy in mammals. The combined effect between Arg and P4 on reproductive parameters in the rabbit species is not yet elucidated, to our best knowledge. Objective: to assess the effect of L-arginine and progesterone during the post-breeding period in female rabbits on the composition of the amniotic fluid, the placental structure, and the bone growth in their fetuses. Methods: crossbred female rabbits (n=16) were randomly distributed into four experimental groups (Ctrl, Arg, P4, and Arg+P4). In the control group, 0.9% saline solution was administered as a placebo, the Arg group was administered arginine (50 mg/kg BW) from day 4.5 to day 19 post-breeding, the P4 group was administered progesterone (Gestavec®, 1.5 mg/kg BW) from 24 hours to day 4 post-breeding and for the Arg+P4 group, an administration was performed under the same time and dose guidelines as the Arg and P4 treatments. Four females were sacrificed, and the amniotic fluid was collected and analyzed with rapid urine test strips, while the placenta and fetuses were processed in the laboratory to obtain histological plates. The percentage of deciduous, labyrinthine, and junctional zones was determined, and the length of the femur for each fetus was measured as an indicator of growth. Descriptive statistics were applied to identify the success rates for each of the tests. Afterwards, A one-way analysis of variance (ANOVA) was performed, and a comparison of means was conducted by Tukey's test. Results: a higher density (p<0.05) was observed in the amniotic fluid for fetuses in the control group (1022±2.5g/mL) compared to the P4 (1015±5.3g/mL) and Arg+P4 (1016±4,9g/mL) groups. Additionally, the density of amniotic fluid in the Arg group (1021±2.5g/mL) was higher (p<0.05) than in the P4 group. The concentration of protein, glucose, and ascorbic acid had no statistical difference between treatments (p>0.05). The histological analysis of the uteroplacental regions, a statistical difference (p<0,05) in the proportion of deciduous zone was found between the P4 group (9.6±2.6%) when compared with the Ctrl (28.15±12.3%), and Arg+P4 (26.3±4.9) groups. In the analysis of the fetuses, the weight was higher for the Arg group (2.69±0.18), compared to the other groups (p<0.05), while a shorter length was observed (p<0.05) in the fetuses for the Arg+P4 group (25.97±1.17). However, no difference (p>0.05) was found when comparing the length of the developing femurs between the experimental groups. Conclusion: the combination of L-arginine and progesterone allows a reduction in the density of amniotic fluid, without affecting the protein, energy, and antioxidant components. However, the use of L-arginine stimulates weight gain in fetuses, without affecting size, which could be used to improve production parameters in rabbit production systems. In addition, the modification in the deciduous zone could show a placental adaptation based on the fetal growth process, however more specific studies on the placentation process are required.

Keywords: arginine, progesterone, rabbits, reproduction

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Authors: Ankan Roy, Niharika, Samir Kumar Patra

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Anomalous nexus of complex topological assemblies and spatiotemporal epigenetic choreography at chromosomal territory may forms the most sophisticated regulatory layer of gene expression in cancer. Colon cancer is one of the leading malignant neoplasms of the lower gastrointestinal tract worldwide. There is still a paucity of information about the complex molecular mechanisms of colonic cancerogenesis. Bioinformatics prediction and analysis helps to identify essential genes and significant pathways for monitoring and conquering this deadly disease. The present study investigates and explores potential hub genes as biomarkers and effective therapeutic targets for colon cancer treatment. Colon cancer patient sample containing gene expression profile datasets, such as GSE44076, GSE20916, and GSE37364 were downloaded from Gene Expression Omnibus (GEO) database and thoroughly screened using the GEO2R tool and Funrich software to find out common 2 differentially expressed genes (DEGs). Other approaches, including Gene Ontology (GO) and KEGG pathway analysis, Protein-Protein Interaction (PPI) network construction and hub gene investigation, Overall Survival (OS) analysis, gene correlation analysis, methylation pattern analysis, and hub gene-Transcription factors regulatory network construction, were performed and validated using various bioinformatics tool. Initially, we identified 166 DEGs, including 68 up-regulated and 98 down-regulated genes. Up-regulated genes are mainly associated with the Cytokine-cytokine receptor interaction, IL17 signaling pathway, ECM-receptor interaction, Focal adhesion and PI3K-Akt pathway. Downregulated genes are enriched in metabolic pathways, retinol metabolism, Steroid hormone biosynthesis, and bile secretion. From the protein-protein interaction network, thirty hub genes with high connectivity are selected using the MCODE and cytoHubba plugin. Survival analysis, expression validation, correlation analysis, and methylation pattern analysis were further verified using TCGA data. Finally, we predicted COL1A1, COL1A2, COL4A1, SPP1, SPARC, and THBS2 as potential master regulators in colonic cancerogenesis. Moreover, our experimental data highlights that disruption of lipid raft and RAS/MAPK signaling cascade affects this gene hub at mRNA level. We identified COL1A1, COL1A2, COL4A1, SPP1, SPARC, and THBS2 as determinant hub genes in colon cancer progression. They can be considered as biomarkers for diagnosis and promising therapeutic targets in colon cancer treatment. Additionally, our experimental data advertise that signaling pathway act as connecting link between membrane hub and gene hub.

Keywords: hub genes, colon cancer, DNA methylation, epigenetic engineering, bioinformatic predictions

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Authors: D. Pogliana, A. Maso, N. Milani, D. Panzin, S. Rivaroli, J. Konin

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This case aims to identify the role of movement quality during the final stage of return to sport (RTS) in a male amateur football player 13 years old after passing the acute phase of the bilateral Osgood-Schlatter disease (OSD). The patient, after a year from passing the acute phase of OSD with the abstention of physical activity, reports bilateral anterior knee pain at the beginning of the football sport activity. Interventions: After the orthopedist check, who recommended physiotherapy sessions for the correction of motor patterns and the isometric reinforcement of the muscles of the quadriceps, the rehabilitation intervention was developed in 7 weeks through 14 sessions of neuro-motor training (NMT) with a frequency of two weekly sessions and six sessions of muscle-strengthening with a frequency of one weekly session. The sessions of NMT were carried out through free body exercises (or with overloads) with visual bio-feedback with the help of two cameras (one with anterior vision and one with lateral vision of the subject) and a big touch screen. The aim of these sessions of NMT was to modify the dysfunctional motor patterns evaluated by the 2D motion analysis test. The test was carried out at the beginning and at the end of the rehabilitation course and included five movements: single-leg squat (SLS), drop jump (DJ), single-leg hop (SLH), lateral shuffle (LS), and change of direction (COD). Each of these movements was evaluated through the video analysis of dynamic valgus knee, pelvic tilt, trunk control, shock absorption, and motor strategy. A free image analysis software (Kinovea) was then used to calculate scores. Results: Baseline assessment of the subject showed a total score of 59% on the right limb and 64% on the left limb (considering an optimal score above 85%) with large deficits in shock absorption capabilities, the presence of dynamic valgus knee, and dysfunctional motor strategies defined “quadriceps dominant.” After six weeks of training, the subject achieved a total score of 80% on the right limb and 86% on the left limb, with significant improvements in shock absorption capabilities, the presence of dynamic knee valgus, and the employment of more hip-oriented motor strategies on both lower limbs. The improvements shown in dynamic knee valgus, greater hip-oriented motor strategies, and improved shock absorption identified through six weeks of the NMT program can help a teenager amateur football player to manage the anterior knee pain during sports activity. In conclusion, NMT was a good choice to help a 13 years old male amateur football player to return to performance without pain after OSD and can also be used with all this type of athletes of the other teams' sports.

Keywords: movement analysis, neuro-motor training, knee pain, movement strategies

Procedia PDF Downloads 116

Authors: Dipendra Kumar Yadav, Nabaraj Paudel, Anjana Yadav

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Background: Low Birth weight (LBW) is defined as the weight at birth less than 2500 grams, irrespective of the period of their gestation. LBW is an important indicator of general health status of population and is considered as the single most important predictors of infant mortality especially of deaths within the first month of life that is birth weight determines the chances of newborn survival. Objective of this study was to identify the maternal risk factors associated with low birth weight neonates. Materials and Methods: A hospital based case-control study was conducted in maternity ward of Manipal Teaching Hospital, Pokhara, Nepal from 23 September 2014 to 12 November 2014. During study period 59 cases were obtained and twice number of control group were selected with frequency matching of the mother`s age with ± 3 years and total controls were 118. Interview schedule was used for data collection along with record review. Data were entered in Epi-data program and analysis was done with help of SPSS software program. Results: From bivariate logistic regression analysis, eighteen variables were found significantly associated with LBW and these were place of residence, family monthly income, education, previous still birth, previous LBW, history of STD, history of vaginal bleeding, anemia, ANC visits, less than four ANC visits, de-worming status, counseling during pregnancy, CVD, physical workload, stress, extra meal during pregnancy, smoking and alcohol consumption status. However after adjusting confounding variables, only six variables were found significantly associated with LBW. Mothers who had family monthly income up to ten thousand rupees were 4.83 times more likely to deliver LBW with CI (1.5-40.645) and p value 0.014 compared to mothers whose family income NRs.20,001-60,000. Mothers who had previous still birth were 2.01 times more likely to deliver LBW with CI (0.69-5.87) and p value 0.02 compared to mothers who did not has previous still birth. Mothers who had previous LBW were 5.472 times more likely to deliver LBW with CI (1.2-24.93) and p value 0.028 compared to mothers who did not has previous LBW. Mothers who had anemia during pregnancy were 3.36 times more likely to deliver LBW with CI (0.77-14.57) and p value 0.014 compared to mothers who did not has anemia. Mothers who delivered female newborn were 2.96 times more likely to have LBW with 95% CI (1.27-7.28) and p value 0.01 compared to mothers who deliver male newborn. Mothers who did not get extra meal during pregnancy were 6.04 times more likely to deliver LBW with CI (1.11-32.7) and p value 0.037 compared to mothers who getting the extra meal during pregnancy. Mothers who consumed alcohol during pregnancy were 4.83 times more likely to deliver LBW with CI (1.57-14.83) and p value 0.006 compared to mothers who did not consumed alcohol during pregnancy. Conclusions: To reduce low birth weight baby through economic empowerment of family and individual women. Prevention and control of anemia during pregnancy is one of the another strategy to control the LBW baby and mothers should take full dose of iron supplements with screening of haemoglobin level. Extra nutritional food should be provided to women during pregnancy. Health promotion program will be focused on avoidance of alcohol and strengthen of health services that leads increasing use of maternity services.

Keywords: low birth weight, case-control, risk factors, hospital based study

Procedia PDF Downloads 291