Search results for: Sharjah-based case study
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 52340

Search results for: Sharjah-based case study

44990 Therapeutic Challenges in Treatment of Adults Bacterial Meningitis Cases

Authors: Sadie Namani, Lindita Ajazaj, Arjeta Zogaj, Vera Berisha, Bahrije Halili, Luljeta Hasani, Ajete Aliu

Abstract:

Background: The outcome of bacterial meningitis is strongly related to the resistance of bacterial pathogens to the initial antimicrobial therapy. The objective of the study was to analyze the initial antimicrobial therapy, the resistance of meningeal pathogens and the outcome of adults bacterial meningitis cases. Materials/methods: This prospective study enrolled 46 adults older than 16 years of age, treated for bacterial meningitis during the years 2009 and 2010 at the infectious diseases clinic in Prishtinë. Patients are categorized into specific age groups: > 16-26 years of age (10 patients), > 26-60 years of age (25 patients) and > 60 years of age (11 patients). All p-values < 0.05 were considered statistically significant. Data were analyzed using Stata 7.1 and SPSS 13. Results: During the two year study period 46 patients (28 males) were treated for bacterial meningitis. 33 patients (72%) had a confirmed bacterial etiology; 13 meningococci, 11 pneumococci, 7 gram-negative bacilli (Ps. aeruginosa 2, Proteus sp. 2, Acinetobacter sp. 2 and Klebsiella sp. 1 case) and 2 staphylococci isolates were found. Neurological complications developed in 17 patients (37%) and the overall mortality rate was 13% (6 deaths). Neurological complications observed were: cerebral abscess (7/46; 15.2%), cerebral edema (4/46; 8.7%); haemiparesis (3/46; 6.5%); recurrent seizures (2/46; 4.3%), and single cases of thrombosis sinus cavernosus, facial nerve palsy and decerebration (1/46; 2.1%). The most common meningeal pathogens were meningococcus in the youngest age group, gram negative-bacilli in second age group and pneumococcus in eldery age group. Initial single-agent antibiotic therapy (ceftriaxone) was used in 17 patients (37%): in 60% of patients in the youngest age group and in 44% of cases in the second age group. 29 patients (63%) were treated with initial dual-agent antibiotic therapy; ceftriaxone in combination with vancomycin or ampicillin. Ceftriaxone and ampicillin were the most commonly used antibiotics for the initial empirical therapy in adults > 50 years of age. All adults > 60 years of age were treated with the initial dual-agent antibiotic therapy as in this age group was recorded the highest mortality rate (M=27%) and adverse outcome (64%). Resistance of pathogens to antimicrobics was recorded in cases caused by gram-negative bacilli and was associated with greater risk for developing neurological complications (p=0.09). None of the gram-negative bacilli were resistant to carbapenems; all were resistant to ampicillin while 5/7 isolates were resistant to cefalosporins. Resistance of meningococci and pneumococci to beta-lactams was not recorded. There were no statistical differences in the occurrence of neurological complications (p > 0.05), resistance of meningeal pathogens to antimicrobics (p > 0.05) and the inital antimicrobial therapy (one vs. two antibiotics) concerning group-ages in adults. Conclusions: The initial antibiotic therapy with ceftriaxone alone or in combination with vancomycin or ampicillin did not cover cases caused by gram-negative bacilli.

Keywords: adults, bacterial meningitis, outcomes, therapy

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44989 Efficiency, Effectiveness, and Technological Change in Armed Forces: Indonesian Case

Authors: Citra Pertiwi, Muhammad Fikruzzaman Rahawarin

Abstract:

Government of Indonesia had committed to increasing its national defense the budget up to 1,5 percent of GDP. However, the budget increase does not necessarily allocate efficiently and effectively. Using Data Envelopment Analysis (DEA), the operational units of Indonesian Armed Forces are considered as a proxy to measure those two aspects. The bootstrap technique is being used as well to reduce uncertainty in the estimation. Additionally, technological change is being measured as a nonstationary component. Nearly half of the units are being estimated as fully efficient, with less than a third is considered as effective. Longer and larger sets of data might increase the robustness of the estimation in the future.

Keywords: bootstrap, effectiveness, efficiency, DEA, military, Malmquist, technological change

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44988 An Investigation of Suppression in Mid-19th Century Japan: Case Study of the 1855 Catfish Prints as a Product of Censorship

Authors: Vasanth Narayanan

Abstract:

The mid-nineteenth century saw the Japanese elite and townsfolk alike undergo the now-infamous Ansei Edo earthquakes. The quakes decimated Japan in the final decades of the Tokugawa Era and, perhaps more consequentially, birthed a new genre of politically inspired artwork, the most notable of which are the namazu-e. This essay advocates an understanding of the 1855 Catfish Prints (namazu-e) that prioritizes the function of iconography and anthropomorphic deity in shaping the namazu-e into a wholly political experience that makes the censorship of the time part of its argument. The visual program is defined as the creation of a politically profitable experience, crafted through the union of explicit religion, highly masked commentary, and the impositions of censorship. The strategies by which the works are designed, in the face of censorship, to engage a less educated, pedestrian audience with its theme, including considerations of iconography, depictions of the working class, anthropomorphism, and the relationship between textual and visual elements, are discussed herein. The essay then takes up the question of the role of tense Japan–United States relations in fostering censorship and as a driver of the production of namazu-e. It is ultimately understood that the marriage of hefty censorship protocol, the explicitly religious medium, and inimical sentiment towards United States efforts at diplomacy renders the production of namazu-e an offspring of the censorship and deeply held frustrations of the time, cementing its status as a primitive form of peaceful protest against a seemingly apathetic government.

Keywords: Japan, Ansei Earthquake, Namazu, prints, censorship, religion

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44987 Hybrid Adaptive Modeling to Enhance Robustness of Real-Time Optimization

Authors: Hussain Syed Asad, Richard Kwok Kit Yuen, Gongsheng Huang

Abstract:

Real-time optimization has been considered an effective approach for improving energy efficient operation of heating, ventilation, and air-conditioning (HVAC) systems. In model-based real-time optimization, model mismatches cannot be avoided. When model mismatches are significant, the performance of the real-time optimization will be impaired and hence the expected energy saving will be reduced. In this paper, the model mismatches for chiller plant on real-time optimization are considered. In the real-time optimization of the chiller plant, simplified semi-physical or grey box model of chiller is always used, which should be identified using available operation data. To overcome the model mismatches associated with the chiller model, hybrid Genetic Algorithms (HGAs) method is used for online real-time training of the chiller model. HGAs combines Genetic Algorithms (GAs) method (for global search) and traditional optimization method (i.e. faster and more efficient for local search) to avoid conventional hit and trial process of GAs. The identification of model parameters is synthesized as an optimization problem; and the objective function is the Least Square Error between the output from the model and the actual output from the chiller plant. A case study is used to illustrate the implementation of the proposed method. It has been shown that the proposed approach is able to provide reliability in decision making, enhance the robustness of the real-time optimization strategy and improve on energy performance.

Keywords: energy performance, hybrid adaptive modeling, hybrid genetic algorithms, real-time optimization, heating, ventilation, and air-conditioning

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44986 Machine Translation Analysis of Chinese Dish Names

Authors: Xinyu Zhang, Olga Torres-Hostench

Abstract:

This article presents a comparative study evaluating and comparing the quality of machine translation (MT) output of Chinese gastronomy nomenclature. Chinese gastronomic culture is experiencing an increased international acknowledgment nowadays. The nomenclature of Chinese gastronomy not only reflects a specific aspect of culture, but it is related to other areas of society such as philosophy, traditional medicine, etc. Chinese dish names are composed of several types of cultural references, such as ingredients, colors, flavors, culinary techniques, cooking utensils, toponyms, anthroponyms, metaphors, historical tales, among others. These cultural references act as one of the biggest difficulties in translation, in which the use of translation techniques is usually required. Regarding the lack of Chinese food-related translation studies, especially in Chinese-Spanish translation, and the current massive use of MT, the quality of the MT output of Chinese dish names is questioned. Fifty Chinese dish names with different types of cultural components were selected in order to complete this study. First, all of these dish names were translated by three different MT tools (Google Translate, Baidu Translate and Bing Translator). Second, a questionnaire was designed and completed by 12 Chinese online users (Chinese graduates of a Hispanic Philology major) in order to find out user preferences regarding the collected MT output. Finally, human translation techniques were observed and analyzed to identify what translation techniques would be observed more often in the preferred MT proposals. The result reveals that the MT output of the Chinese gastronomy nomenclature is not of high quality. It would be recommended not to trust the MT in occasions like restaurant menus, TV culinary shows, etc. However, the MT output could be used as an aid for tourists to have a general idea of a dish (the main ingredients, for example). Literal translation turned out to be the most observed technique, followed by borrowing, generalization and adaptation, while amplification, particularization and transposition were infrequently observed. Possibly because that the MT engines at present are limited to relate equivalent terms and offer literal translations without taking into account the whole context meaning of the dish name, which is essential to the application of those less observed techniques. This could give insight into the post-editing of the Chinese dish name translation. By observing and analyzing translation techniques in the proposals of the machine translators, the post-editors could better decide which techniques to apply in each case so as to correct mistakes and improve the quality of the translation.

Keywords: Chinese dish names, cultural references, machine translation, translation techniques

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44985 Stress and Overload in Mothers and Fathers of Hospitalized Children: A Comparative Study

Authors: Alessandra Turini Bolsoni Silva, Nilson Rogério Da Silva

Abstract:

The hospitalization process for long periods and the experience of invasive and painful clinical procedures can trigger a set of stressors in children, family members and professionals, leading to stress. Mothers are, in general, the main caregivers and, therefore, have a high degree of sadness and stress with an impact on mental health. However, the father, in the face of the mother's absence, needs to assume other responsibilities such as domestic activities and healthy children in addition to work activities. In addition, he has to deal with changes in family and work relationships during the child's hospitalization, with disagreements and changes in the relationship with the partner, changes in the relationship with the children, and finding it difficult to reconcile the new tasks as a caregiver and work. A consequence of the hospitalization process is the interruption of the routine activities of both the child and the family members responsible for the care, who can go through stressful moments due to the consequences of family breakdown, attention focused only on the child and sleepless nights. In this sense, both the mother and the father can have their health affected by their child's hospitalization. The present study aims to compare the prevalence of stress and overload in mothers and fathers of hospitalized children, as well as possible associations with activities related to care. The participants were 10 fathers and 10 mothers of children hospitalized in a hospital located in a medium-sized city in the interior of São Paulo. Three instruments were used for data collection: 1) Script to characterize the participants; 2) The Lipp Stress Symptom Inventory (ISSL, 2000) 3) Zarit Burden Interview Protocol – ZBT. Contact was made with the management of the hospital in order to present the objectives of the project, then authorization was requested for the participation of the parents; after an agreement, the time and place were convenient for the participant to carry out the interview. Thus, they signed the Free and Informed Consent Term. Data were analyzed according to the instrument application manuals and organized in Figures and Tables. The results revealed that fathers and mothers have their family and professional routine affected by the hospitalization of their children, with the consequent presence of stress and overload indicators. However, the study points to a greater presence of stress and overload in mothers due to their role as the main caregiver, often interrupting their professional life to exercise care. In the case of the father, the routine is changed due to taking on household chores and taking care of the other children, with the professional life being less affected. It is hoped that the data can guide future interventions that promote and develop strategies that favor care and, at the same time, preserve the health of caregivers and that include mothers and fathers, considering that both are affected, albeit in a different way.

Keywords: stress, overload, caregivers, parents

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44984 Energy Efficiency and Sustainability Analytics for Reducing Carbon Emissions in Oil Refineries

Authors: Gaurav Kumar Sinha

Abstract:

The oil refining industry, significant in its energy consumption and carbon emissions, faces increasing pressure to reduce its environmental footprint. This article explores the application of energy efficiency and sustainability analytics as crucial tools for reducing carbon emissions in oil refineries. Through a comprehensive review of current practices and technologies, this study highlights innovative analytical approaches that can significantly enhance energy efficiency. We focus on the integration of advanced data analytics, including machine learning and predictive modeling, to optimize process controls and energy use. These technologies are examined for their potential to not only lower energy consumption but also reduce greenhouse gas emissions. Additionally, the article discusses the implementation of sustainability analytics to monitor and improve environmental performance across various operational facets of oil refineries. We explore case studies where predictive analytics have successfully identified opportunities for reducing energy use and emissions, providing a template for industry-wide application. The challenges associated with deploying these analytics, such as data integration and the need for skilled personnel, are also addressed. The paper concludes with strategic recommendations for oil refineries aiming to enhance their sustainability practices through the adoption of targeted analytics. By implementing these measures, refineries can achieve significant reductions in carbon emissions, aligning with global environmental goals and regulatory requirements.

Keywords: energy efficiency, sustainability analytics, carbon emissions, oil refineries, data analytics, machine learning, predictive modeling, process optimization, greenhouse gas reduction, environmental performance

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44983 Backward Erosion Piping through Vertically Layered Sands

Authors: K. Vandenboer, L. Dolphen, A. Bezuijen

Abstract:

Backward erosion piping is an important failure mechanism for water-retaining structures, a phenomenon that results in the formation of shallow pipes at the interface of a sandy or silty foundation and a cohesive cover layer. This paper studies the effect of two soil types on backward erosion piping; both in case of a homogeneous sand layer, and in a vertically layered sand sample, where the pipe is forced to subsequently grow through the different layers. Two configurations with vertical sand layers are tested; they both result in wider pipes and higher critical gradients, thereby making this an interesting topic in research on measures to prevent backward erosion piping failures.

Keywords: backward erosion piping, embankments, physical modeling, sand

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44982 Improvement in Drought Stress Tolerance in Wheat by Arbuscular Mycorrhizal Fungi

Authors: Seema Sangwan, Ekta Narwal, Kannepalli Annapurna

Abstract:

The aim of this study was to determine the effect of arbuscular mycorrhizal fungi (AMF) inoculation on drought stress tolerance in 3 genotypes of wheat subjected to moderate water stress, i.e. HD 3043 (drought tolerant), HD 2987 (drought tolerant), and HD 2967 (drought sensitive). Various growth parameters were studied, e.g. total dry weight, total shoot and root length, root volume, root surface area, grain weight and number, leaf area, chlorophyll content in leaves, relative water content, number of spores and percent colonisation of roots by arbuscular mycorrhizal fungi. Total dry weight, root surface area and chlorophyll content were found to be significantly high in AMF inoculated plants as compared to the non-mycorrhizal ones and also higher in drought-tolerant varieties of wheat as compared to the sensitive variety HD 2967, in moderate water stress treatments. Leakage of electrolytes was lower in case of AMF inoculated stressed plants. Under continuous water stress, leaf water content and leaf area were significantly increased in AMF inoculated plants as compared to un-inoculated stressed plants. Overall, the increased colonisation of roots of wheat by AMF in inoculated plants weather drought tolerant or sensitive could have a beneficial effect in alleviating the harmful effects of water stress in wheat and delaying its senescence.

Keywords: Arbuscular mycorrhizal fungi, wheat, drought, stress

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44981 Integrating Road Safety into Mainstreaming Education and Other Initiatives with Holistic Approach in the State: A Case Study of Madhya Pradesh, India

Authors: Yogesh Mahor, Subhash Nigam, Abhai Khare

Abstract:

Road safety education is a composite subject which should be viewed holistically if taken into accoubehavior change communication, safe road infrastructure and low enforcement. Specific and customized road safety education is crucial for each type of road user and learners in the formal and informal teaching and various kind of training programs directly sponsored by state and center government, as they are active contributors to shaping a community and responsible citizens. The aim of this discussion article is to explore a strategy to integrate road safety education into the formal curriculum of schools, higher education institutions, driving schools, skill development centers, various government funded urban and rural development training institutions and their work plans as standing agenda. By applying the desktop research method, the article conceptualizes what the possible focus of road safety education and training should be. The article then explores international common practices in road safety education and training, and considers the necessary synergy between education, road engineering and low enforcement. The article uses secondary data collected from documents which are then analysed in a sectoral way. A well-designed road safety strategy for mainstreaming education and government-sponsored training is urgently needed, facilitating partnerships in various sectors to implement such education in the students and learners in multidisciplinary ways.

Keywords: road safety education, curriculum-based road safety education, behavior change communication, low enforcement, road engineering, safe system approach, infrastructure development consultants

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44980 Effectiveness of Catalysis in Ozonation for the Removal of Herbizide 2,4 Dichlorophenoxyacetic Acid from Contaminated Water

Authors: S. Shanthi

Abstract:

Catalyzed oxidation processes show extraordinary guarantee for application in numerous wastewater treatment ranges. Advanced oxidation processes are emerging innovation that might be utilized for particular objectives in wastewater treatment. This research work provides a solution for removal a refractory organic compound 2,4-dichlorophenoxyaceticacid a common water pollutant. All studies were done in batch mode in a constantly stirred reactor. Alternative ozonation processes catalysed by transition metals or granular activated carbon have been investigated for degradation of organics. Catalytic ozonation under study are homogeneous catalytic ozonation, which is based on ozone activation by transition metal ions present in aqueous solution, and secondly as heterogeneous catalytic ozonation in the presence of Granular Activated Carbon (GAC). The present studies reveal that heterogeneous catalytic ozonation using GAC favour the ozonation of 2,4-dichlorophenoxyaceticacid by increasing the rate of ozonation and a much higher degradation of substrates were obtained in a given time. Be that it may, Fe2+and Fe3+ ions decreased the rate of degradation of 2,4-dichlorophenoxyaceticacid indicating that it acts as a negative catalyst. In case of heterogeneous catalytic ozonation using GAC catalyst it was found that during the initial 5 minutes of contact solution concentration decreased significantly as the pollutants were adsorbed initially. Thereafter the substrate started getting oxidized and ozonation became a dominates the treatment process. The exhausted GAC was found to be regenerated in situ. The percentage reduction of the substrate was maximum achieved in minimum possible time when GAC catalyst is employed.

Keywords: ozonation, homogeneous catalysis, heterogeneous catalysis, granular activated carbon

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44979 From Government-Led to Collective Action: A Case Study of the Transformation of Urban Renewal Governance in Nanjing, China

Authors: Hanjun Hu, Jinxiang Zhang

Abstract:

With the decline of "growthism", China's urbanization process has shifted from the stage of spatial expansion to the stage of optimization of built-up spaces, and urban renewal has gradually become a new wave of China's urban movement in recent years. The ongoing urban renewal movement in China not only needs to generate new motivation for urban development but also solve the backlog of social problems caused by rapid urbanization, which provides an opportunity for the transformation of China's urban governance model. Unlike previous approaches that focused on physical space and functional renewal, such as urban reconstruction, redevelopment, and reuse, the key challenge of urban renewal in the post-growth era lies in coordinating the complex interest relationships between multiple stakeholders. The traditional theoretical frameworks that focus on the structural relations between social groups are insufficient to explain the behavior logic and mutual cooperation mechanism of various groups and individuals in the current urban renewal practices. Therefore, based on the long-term tracking of the urban renewal practices in the Old City of Nanjing (OCN), this paper introduces the "collective action" theory to deeply analyze changes in the urban renewal governance model in OCN and tries to summarize the governance strategies that promote the formation of collective action within recent practices from a micro-scale. The study found that the practice in OCN experienced three different stages "government-led", "growth coalition" and "asymmetric game". With the transformation of government governance concepts, the rise of residents' consciousness of rights, and the wider participation of social organizations in recent years, the urban renewal in OCN is entering a new stage of "collective renewal action". Through the establishment of the renewal organization model, incentive policies, and dynamic negotiation mechanism, urban renewal in OCN not only achieves a relative balance between individual interests and collective interests but also makes the willingness of residents the dominant factor in formulating urban renewal policies. However, the presentation of "collective renewal action" in OCN is still mainly based on typical cases. Although the government is no longer the dominant role, a large number of resident-led collective actions have not yet emerged, which puts forward new research needs for a sustainable governance policy innovation in this action.

Keywords: urban renewal, collective action theory, governance, cooperation mechanism, China

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44978 Metanotes and Foreign Language Learning: A Case of Iranian EFL Learners

Authors: Nahıd Naderı Anarı, Mojdeh Shafıee

Abstract:

Languaging has been identified as a contributor to language learning. Compared to oral languaging, written languaging seems to have been less explored. In order to fill this gap, this paper examined the effect of ‘metanotes’, namely metatalk in a written modality to identify whether written languaging actually facilitates language learning. Participants were instructed to take metanotes as they performed a translation task. The effect of metanotes was then analyzed by comparing the results of these participants’ pretest and posttest with those of participants who performed the same task without taking metanotes. The statistical tests showed no evidence of the expected role of metanotes in foreign language learning.

Keywords: EFL learners, foreign language learning, language teaching, metanotes

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44977 Influence of Pseudomonas japonica on Growth and Metal Tolerance of Celosia cristata L.

Authors: Muhammad Umair Mushtaq, Ameena Iqbal, Muhammad Aqib Hassan Ali Khan, Ismat Nawaz, Sohail Yousaf, Mazhar Iqbal

Abstract:

Heavy metals are one of the priority pollutants as they pose serious health and environmental threats. They can be removed by various physiochemical methods but are costly and responsible for additional environmental problems. Bioremediation that exploits plants and their associated microbes have been referred as cost effective and environmental friendly technique. In this study, a pot experiment was conducted in a greenhouse to evaluate the potential of Celosia cristata and effects of bacteria, Pseudomonas japonica, and organic amendment moss/compost on tolerating/accumulating heavy metals. Two weeks old seedlings were transferred to soil in pots, and after four weeks they were inoculated with bacterial strain, while after growth of six weeks they were watered with a metal containing synthetic wastewater and were harvested after a growth period of nine weeks. After harvesting, morphological and physiological parameters and metal content of plants were measured. The results showed highest plant growth and biomass production in case of organic amendments while highest metal uptake has been found in non-amended pots. Positive controls have shown highest Pb uptake of 2900 mg/kg DW, while P. japonica amended pots have shown highest Cd, Cr, Ni and Cu uptake of 963.53, 1481.17, 1022.01 and 602.17 mg/kg DW, respectively. In conclusion organic amendments have strong impacts on growth enhancement while P. japonica enhances metal translocation and accumulation to aerial parts with little significant involvement in plant growth.

Keywords: ornamental plants, plant microbe interaction, amendments, bacteria

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44976 The Development of OTOP Web Application: Case of Samut Songkhram Province

Authors: Satien Janpla, Kunyanuth Kularbphettong

Abstract:

This paper aims to present the development of a web‑based system to serve the need of selling OTOP products in Samut Songkhram, Thailand. This system was designed to promote and sell OTOP products on website. We describe the design approaches and functional components of this system. The system was developed by PHP and JavaScript and MySQL database System. To evaluate the system performance, questionnaires were used to measure user satisfaction with system usability by specialists and users. The results were satisfactory as followed: Means for specialists and users were 4.05 and 3.97, and standard deviation for specialists and users were 0.563 and 0.644 respectively. Further analysis showed that the quality of One Tambon One Product (OTOP) Website was also at a good level as well.

Keywords: web-based system, OTOP, product, website

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44975 A Study of Seismic Design Approaches for Steel Sheet Piles: Hydrodynamic Pressures and Reduction Factors Using CFD and Dynamic Calculations

Authors: Helena Pera, Arcadi Sanmartin, Albert Falques, Rafael Rebolo, Xavier Ametller, Heiko Zillgen, Cecile Prum, Boris Even, Eric Kapornyai

Abstract:

Sheet piles system can be an interesting solution when dealing with harbors or quays designs. However, current design methods lead to conservative approaches due to the lack of specific basis of design. For instance, some design features still deal with pseudo-static approaches, although being a dynamic problem. Under this concern, the study particularly focuses on hydrodynamic water pressure definition and stability analysis of sheet pile system under seismic loads. During a seismic event, seawater produces hydrodynamic pressures on structures. Currently, design methods introduce hydrodynamic forces by means of Westergaard formulation and Eurocodes recommendations. They apply constant hydrodynamic pressure on the front sheet pile during the entire earthquake. As a result, the hydrodynamic load may represent 20% of the total forces produced on the sheet pile. Nonetheless, some studies question that approach. Hence, this study assesses the soil-structure-fluid interaction of sheet piles under seismic action in order to evaluate if current design strategies overestimate hydrodynamic pressures. For that purpose, this study performs various simulations by Plaxis 2D, a well-known geotechnical software, and CFD models, which treat fluid dynamic behaviours. Knowing that neither Plaxis nor CFD can resolve a soil-fluid coupled problem, the investigation imposes sheet pile displacements from Plaxis as input data for the CFD model. Then, it provides hydrodynamic pressures under seismic action, which fit theoretical Westergaard pressures if calculated using the acceleration at each moment of the earthquake. Thus, hydrodynamic pressures fluctuate during seismic action instead of remaining constant, as design recommendations propose. Additionally, these findings detect that hydrodynamic pressure contributes a 5% to the total load applied on sheet pile due to its instantaneous nature. These results are in line with other studies that use added masses methods for hydrodynamic pressures. Another important feature in sheet pile design is the assessment of the geotechnical overall stability. It uses pseudo-static analysis since the dynamic analysis cannot provide a safety calculation. Consequently, it estimates the seismic action. One of its relevant factors is the selection of the seismic reduction factor. A huge amount of studies discusses the importance of it but also about all its uncertainties. Moreover, current European standards do not propose a clear statement on that, and they recommend using a reduction factor equal to 1. This leads to conservative requirements when compared with more advanced methods. Under this situation, the study calibrates seismic reduction factor by fitting results from pseudo-static to dynamic analysis. The investigation concludes that pseudo-static analyses could reduce seismic action by 40-50%. These results are in line with some studies from Japanese and European working groups. In addition, it seems suitable to account for the flexibility of the sheet pile-soil system. Nevertheless, the calibrated reduction factor is subjected to particular conditions of each design case. Further research would contribute to specifying recommendations for selecting reduction factor values in the early stages of the design. In conclusion, sheet pile design still has chances for improving its design methodologies and approaches. Consequently, design could propose better seismic solutions thanks to advanced methods such as findings of this study.

Keywords: computational fluid dynamics, hydrodynamic pressures, pseudo-static analysis, quays, seismic design, steel sheet pile

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44974 The Effect of Accounting Conservatism on Cost of Capital: A Quantile Regression Approach for MENA Countries

Authors: Maha Zouaoui Khalifa, Hakim Ben Othman, Hussaney Khaled

Abstract:

Prior empirical studies have investigated the economic consequences of accounting conservatism by examining its impact on the cost of equity capital (COEC). However, findings are not conclusive. We assume that inconsistent results of such association may be attributed to the regression models used in data analysis. To address this issue, we re-examine the effect of different dimension of accounting conservatism: unconditional conservatism (U_CONS) and conditional conservatism (C_CONS) on the COEC for a sample of listed firms from Middle Eastern and North Africa (MENA) countries, applying quantile regression (QR) approach developed by Koenker and Basset (1978). While classical ordinary least square (OLS) method is widely used in empirical accounting research, however it may produce inefficient and bias estimates in the case of departures from normality or long tail error distribution. QR method is more powerful than OLS to handle this kind of problem. It allows the coefficient on the independent variables to shift across the distribution of the dependent variable whereas OLS method only estimates the conditional mean effects of a response variable. We find as predicted that U_CONS has a significant positive effect on the COEC however, C_CONS has a negative impact. Findings suggest also that the effect of the two dimensions of accounting conservatism differs considerably across COEC quantiles. Comparing results from QR method with those of OLS, this study throws more lights on the association between accounting conservatism and COEC.

Keywords: unconditional conservatism, conditional conservatism, cost of equity capital, OLS, quantile regression, emerging markets, MENA countries

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44973 Just a Heads Up: Approach to Head Shape Abnormalities

Authors: Noreen Pulte

Abstract:

Prior to the 'Back to Sleep' Campaign in 1992, 1 of every 300 infants seen by Advanced Practice Providers had plagiocephaly. Insufficient attention is given to plagiocephaly and brachycephaly diagnoses in practice and pediatric education. In this talk, Nurse Practitioners and Pediatric Providers will be able to: (1) identify red flags associated with head shape abnormalities, (2) learn techniques they can teach parents to prevent head shape abnormalities, and (3) differentiate between plagiocephaly, brachycephaly, and craniosynostosis. The presenter is a Primary Care Pediatric Nurse Practitioner at Ann & Robert H. Lurie Children's Hospital of Chicago and the primary provider for its head shape abnormality clinics. She will help participants translate key information obtained from birth history, review of systems, and developmental history to understand risk factors for head shape abnormalities and progression of deformities. Synostotic and non-synostotic head shapes will be explained to help participants differentiate plagiocephaly and brachycephaly from synostotic head shapes. This knowledge is critical for the prompt referral of infants with craniosynostosis for surgical evaluation and correction. Rapid referral for craniosynostosis can possibly direct the patient to a minimally invasive surgical procedure versus a craniectomy. As for plagiocephaly and brachycephaly, this timely referral can also aid in a physical therapy referral if necessitated, which treats torticollis and aids in improving head shape. A well-timed referral to a head shape clinic can possibly eliminate the need for a helmet and/or minimize the time in a helmet. Practitioners will learn the importance of obtaining head measurements using calipers. The presenter will explain head calculations and how the calculations are interpreted to determine the severity of the head shape abnormalities. Severity defines the treatment plan. Participants will learn when to refer patients to a head shape abnormality clinic and techniques they should teach parents to perform while waiting for the referral appointment. The purpose, mechanics, and logistics of helmet therapy, including optimal time to initiate helmet therapy, recommended helmet wear-time, and tips for helmet therapy compliance, will be described. Case scenarios will be incorporated into the presenter's presentation to support learning. The salient points of the case studies will be explained and discussed. Practitioners will be able to immediately translate the knowledge and skills gained in this presentation into their clinical practice.

Keywords: plagiocephaly, brachycephaly, craniosynostosis, red flags

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44972 Effect of B2O3 Addition on Sol-gel Synthesized 45S5 Bioglass

Authors: P. Dey, S. K. Pal

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Ceramics or glass ceramics with the property of bone bonding at the nearby tissues and producing possible bone in growth are known to be bioactive. The most extensively used glass in this context is 45S5 which is a silica based bioglass mostly explored in the field of tissue engineering as scaffolds for bone repair. Nowadays, the borate based bioglass are being utilized in orthopedic area largely due to its superior bioactivity with the formation of bone bonding. An attempt has been made, in the present study, to observe the effect of B2O3 addition in 45S5 glass and perceive its consequences on the thermal, mechanical and biological properties. The B2O3 was added in 1, 2.5, and 5 wt% with simultaneous reduction in the silica content of the 45S5 composition. The borate based bioglass has been synthesized by the means of sol-gel route. The synthesized powders were then thermally analyzed by DSC-TG. The as synthesized powders were then calcined at 600ºC for 2hrs. The calcined powders were then pressed into pellets followed by sintering at 850ºC with a holding time of 2hrs. The phase analysis and the microstructural analysis of the as synthesized and calcined powder glass samples and the sintered glass samples were being carried out using XRD and FESEM respectively. The formation of hydroxyapatite layer was performed by immersing the sintered samples in the simulated body fluid (SBF) and mechanical property has been tested for the sintered samples by universal testing machine (UTM). The sintered samples showed the presence of sodium calcium silicate phase while the formation of hydroxyapaptite takes place for SBF immersed samples. The formation of hydroxyapatite is more pronounced in case of borated based glass samples instead of 45S5.

Keywords: 45S5 bioglass, bioactive, borate, hydroxyapatite, sol-gel synthesis

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44971 Comparative Study on Efficacy and Clinical Outcomes in Minimally Invasive Surgery Transforaminal Interbody Fusion vs Minimally Invasive Surgery Lateral Interbody Fusion

Authors: Sundaresan Soundararajan, George Ezekiel Silvananthan, Chor Ngee Tan

Abstract:

Introduction: Transforaminal Interbody Fusion (TLIF) has been adopted for many decades now, however, XLIF, still in relative infancy, has grown to be accepted as a new Minimally Invasive Surgery (MIS) option. There is a paucity of reports directly comparing lateral approach surgery to other MIS options such as TLIF in the treatment of lumbar degenerative disc diseases. Aims/Objectives: The objective of this study was to compare the efficacy and clinical outcomes between Minimally Invasive Transforaminal Interbody Fusion (TLIF) and Minimally Invasive Lateral Interbody Fusion (XLIF) in the treatment of patients with degenerative disc disease of the lumbar spine. Methods: A single center, retrospective cohort study involving a total of 38 patients undergoing surgical intervention between 2010 and 2013 for degenerative disc disease of lumbar spine at single L4/L5 level. 18 patients were treated with MIS TLIF, and 20 patients were treated with XLIF. Results: The XLIF group showed shorter duration of surgery compared to the TLIF group (176 mins vs. 208.3 mins, P = 0.03). Length of hospital stay was also significantly shorter in XLIF group (5.9 days vs. 9 days, p = 0.03). Intraoperative blood loss was favouring XLIF as 85% patients had blood loss less than 100cc compared to 58% in the TLIF group (P = 0.03). Radiologically, disc height was significantly improved post operatively in the XLIF group compared to the TLIF group (0.56mm vs. 0.39mm, P = 0.01). Foraminal height increment was also higher in the XLIF group (0.58mm vs. 0.45mm , P = 0.06). Clinically, back pain and leg pain improved in 85% of patients in the XLIF group and 78% in the TLIF group. Post op hip flexion weakness was more common in the XLIF group (40%) than in the TLIF group (0%). However, this weakness resolved within 6 months post operatively. There was one case of dural tear and surgical site infection in the TLIF group respectively and none in the XLIF group. Visual Analog Scale (VAS) score 6 months post operatively showed comparable reduction in both groups. TLIF group had Owsterty Disability Index (ODI) improvement on 67% while XLIF group showed improvement of 70% of its patients. Conclusions: Lateral approach surgery shows comparable clinical outcomes in resolution of back pain and radiculopathy to conventional MIS techniques such as TLIF. With significantly shorter duration of surgical time, minimal blood loss and shorter hospital stay, XLIF seems to be a reasonable MIS option compared to other MIS techniques in treating degenerative lumbar disc diseases.

Keywords: extreme lateral interbody fusion, lateral approach, minimally invasive, XLIF

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44970 A Review of Critical Factors in Budgetary Financing of Public Infrastructure in Nigeria

Authors: Akintayo Opawole, Godwin O. Jagboro

Abstract:

Research efforts on infrastructure development in Nigeria had not provided adequate assessment of issues essential for policy response by the government to address infrastructure deficiency. One major gap existing in previous studies is the assessment of challenges facing the budgetary financing model. Based on a case study of Osun State in Southwestern Nigeria, factors affecting budgetary financing of public infrastructure were identified from literature and brainstorming. Respondents were: 6 architects, 4 quantity surveyors, 6 town planners, 5 estate surveyors, 4 builders, 21 engineers and 26 economists/accountants ranging from principal to director who have been involved in policy making process with respect to infrastructure development in the public service of Osun state. The identified variables were subjected to factor analysis. The Kaiser-Meyer-Olkin measure of sampling adequacy tests carried out (KMO, 0.785) showed that the data collected were adequate for the analysis and the Bartlett’s test of sphericity (0.000) showed the data upon which the analysis was carried out was reliable. Results showed that factors such as poor collaboration between the state and local government establishments, absence of credible database system and inadequate funding of maintenance were the most significant to infrastructure development in the State. Policy responses to address challenges of infrastructure development in the state were identified to focus on creation of legal framework for liberation policy, enforcement of ‘due process’ in the procurement and establishment of monitoring system for project delivery.

Keywords: development, infrastructure, financing, procurement

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44969 Elements of Critical Event Management: A Qualitative Study of Trauma Teams

Authors: Tan Xin Zhong Timothy, Chang Chen Jie Victor, Yew Kwan Tong, Lim Geok Peng Sandy

Abstract:

Background: Leaders in crisis response teams such as Trauma Teams in hospitals are essential to the effective coordination and direction of the team. The response to emergency trauma situations must be accurate, rapid, and well executed. To this end, the team leader’s social, technical and leadership skills are essential factors that implicate the success of an emergency trauma intervention. While each emergency trauma case varies in severity and complexity, and the experience and expertise of team leaders may vary, it would be productive to identify certain coordinative and directive functions that improve the capacity for leading a team. Methods: This qualitative study of Trauma Team physicians in Singapore General Hospital (SGH) involved 50 in-depth interviews with doctors and nurses involved in Trauma Team activations, observations of Trauma Teams managing emergency patients, and reviews of audio/video recordings of 65 trauma activations. The interviews were conducted with doctors of various ranks across the relevant departments, 12 from the Emergency Department (ED), 11 from General Surgery (GS) and 8 from Orthopaedics, while the 6 nurses were from ED. In accordance with the grounded theory approach, the content of the interviews was coded and analysed in order to derive broad leadership themes that corresponded with certain behavioural traits exhibited by trauma team leaders, supplemented with the observational and audio/video data. Results: The leadership behaviours of the team leaders could be typified into three broad categories: team orientation, engagement and activeness. Team orientation corresponds with the source and form of cognitive responsibility, decision-making and informational contributions, divisible into individualistic and consultative sub-categories. Engagement refers to the type of activity that leaders prefer to engage in, and which implicates their attentional focus, divisible into participatory and supervisory sub-categories. Activeness is a function of the leader’s attitudes towards the behavioural regulation of the team, which manifests in inactivity or activity to augment or merely align with protocol. These factors are not exhaustive and are contextually sensitive, but collectively implicate a significant portion of the leadership activity observed in trauma teams.

Keywords: trauma team activations, critical event management, leadership, teamwork

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44968 Circular Economy: An Overview of Principles, Strategies, and Case Studies

Authors: Dina Mohamed Ahmed Mahmoud Bakr

Abstract:

The concept of a circular economy is gaining increasing attention as a way to promote sustainable economic growth and reduce the environmental impact of human activities. The circular economy is a systemic approach that aims to keep materials and resources in use for as long as possible, minimize waste and pollution, and regenerate natural systems. The purpose of this article is to present a summary of the principles and tactics employed in the circular economy, along with examples of prosperous circular economy projects implemented in different sectors across Japan, Austria, the Netherlands, South Africa, Germany, and the United States. The paper concludes with a discussion of the challenges and opportunities associated with the transition to a circular economy and the policy interventions that can support this transition.

Keywords: circular economy, waste reduction, sustainable development, recycling

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44967 Developing Commitment to Change in Egyptian Modern Bureaucracies

Authors: Nada Basset

Abstract:

Purpose: To examine the nature of the civil service sector as an employer through identifying the likely ways to develop employees’ commitment towards change in the civil service sector. Design/Methodology/Approach: a qualitative research approach was followed. Data was collected via a triangulation of interviews, non-participant observation and archival documents analysis. Non-probability sampling took place with a case-study method applied on a sample of 33 civil servants working in the Egyptian Ministry of State for Administrative Development (MSAD) which is the civil service entity acting as the change agent responsible for managing the government administrative reforms plan in the civil service sector. All study participants were actually working in one of the change projects/programmes and had a minimum of 12 months of service in the civil service. Interviews were digitally recorded and transcribed in the form of MS-Word documents, and data transcripts were analyzed manually using MS-Excel worksheets and main research themes were developed and statistics drawn using those Excel worksheets. Findings: The results demonstrate that developing the civil servant’s commitment towards change may require a number of suggested solutions like (1) employee involvement and participation in the planning and implementation processes, (2) linking the employee support to change to some tangible rewards and incentives, (3) appointing some inspirational change leaders that should act as role models, and (4) as a last resort, enforcing employee’s commitment towards change by coercion and authoritarianism. Practical Implications: it is clear that civil servants’ lack of organizational commitment is not directly related to their level of commitment towards change. The research findings showed that civil servants’ commitment towards change can be raised and promoted by getting them involved in the planning and implementation processes, as this develops some sense of belongingness and ownership, thus there is a fair chance that low organizationally committed civil servants can develop high commitment towards change; given they are provided a favorable environment where they are invited to participate and get involved into the move of change. Originality/Value: the research addresses a relatively new area of ‘developing organizational commitment in modern bureaucracies’ by virtue of investigating the levels of civil servants’ commitment towards their jobs and/or organizations -on one hand- and suggesting different ways of developing their commitment towards administrative reform and change initiatives in the Egyptian civil service sector.

Keywords: change, commitment, Egypt, bureaucracy

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44966 Exploring Polar Syntactic Effects of Verbal Extensions in Basà Language

Authors: Imoh Philip

Abstract:

This work investigates four verbal extensions; two in each set resulting in two opposite effects of the valency of verbs in Basà language. Basà language is an indigenous language spoken in Kogi, Nasarawa, Benue, Niger states and all the Federal Capital Territory (FCT) councils. Crozier & Blench (1992) and Blench & Williamson (1988) classify Basà as belonging to Proto–Kru, under the sub-phylum Western –Kru. It studies the effects of such morphosyntactic operations in Basà language with special focus on ‘reflexives’ ‘reciprocals’ versus ‘causativization’ and ‘applicativization’ both sets are characterized by polar syntactic processes of either decreasing or increasing the verb’s valency by one argument vis-à-vis the basic number of arguments, but by the similar morphological processes. In addition to my native intuitions as a native speaker of Basà language, data elicited for this work include discourse observation, staged and elicited spoken data from fluent native speakers. The paper argues that affixes attached to the verb root, result in either deriving an intransitive verb from a transitive one or a transitive verb from a bi/ditransitive verb and equally increase the verb’s valence deriving either a bitransitive verb from a transitive verb or a transitive verb from a intransitive one. Where the operation increases the verb’s valency, it triggers a transformation of arguments in the derived structure. In this case, the applied arguments displace the inherent ones. This investigation can stimulate further study on other transformations that are either syntactic or morphosyntactic in Basà and can also be replicated in other African and non-African languages.

Keywords: verbal extension, valency, reflexive, reciprocal, causativization, applicativization, Basà

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44965 The Role of an Independent Children’s Lawyer in Child Inclusive Mediation in Complex Parenting Disputes

Authors: Neisha Shepherd

Abstract:

In Australia, an independent children's lawyer is appointed to represent a child in parenting disputes in the Federal Circuit and Family Court of Australia, where there are complex issues such as child protection, family violence, high conflict, relocation, and parental alienation. The appointment of an Independent Children's Lawyer is to give effect in the family law proceedings of the United Nations Convention on the Rights of the Child, in particular Article 3.1, 12.1, and 12.2. There is a strong focus on alternative dispute resolution in the Australian Family Law jurisdiction in matters that are before the Court that has formed part of the case management pathways. An Independent Children's Lawyer's role is even more crucial in assisting families in resolving the most complex parenting disputes through mediation as they are required to act impartial and be independent of the Court and the parties. A child has the right to establish a professional relationship with the Independent Children's Lawyer. This relationship is usually established over a period of time, and the child is afforded the opportunity to talk about their views and wishes and participate in decisions that affect them. In considering the views and wishes of the child, the Independent Children's lawyer takes into account the different emotional, cognitive, and intellectual developmental levels, family structures, family dynamics, sibling relationships, religious and cultural backgrounds; and that children are vulnerable to external pressures when caught in disputes involving their parents. With the increase of child-inclusive mediations being used to resolve family disputes in the best interests of a child, an Independent Children's Lawyer can have a critical role in this process with the specialised skills that they have working with children in the family law jurisdiction. This paper will discuss how inclusive child mediation with the assistance of an Independent Children's Lawyer can assist in the resolution of some of the most complex parenting disputes by examining through case studies: the effectiveness and challenges of such an approach; strategies to work with child clients, adolescents, and sibling groups; ways to provide feedback regarding a child's views and wishes and express a child's understanding, actual experiences and perspective to parties in a mediation and whether it is appropriate to do so; strategies and examples to assist in developing parenting plans or orders that are in the best interest of a child that is workable and achievable; how to deal with cases that involve serious child protection and family violence and strategies to ensure that child safety is paramount; the importance of feedback to the child client. Finally this paper will explore some of the challenges for Independent Children's Lawyers in relation to child-inclusive mediations where matters do not resolve.

Keywords: child inclusive mediation, independent children's lawyer, family violence, child protection

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44964 Scheduling Method for Electric Heater in HEMS considering User’s Comfort

Authors: Yong-Sung Kim, Je-Seok Shin, Ho-Jun Jo, Jin-O Kim

Abstract:

Home Energy Management System (HEMS) which makes the residential consumers contribute to the demand response is attracting attention in recent years. An aim of HEMS is to minimize their electricity cost by controlling the use of their appliances according to electricity price. The use of appliances in HEMS may be affected by some conditions such as external temperature and electricity price. Therefore, the user’s usage pattern of appliances should be modeled according to the external conditions, and the resultant usage pattern is related to the user’s comfortability on use of each appliances. This paper proposes a methodology to model the usage pattern based on the historical data with the copula function. Through copula function, the usage range of each appliance can be obtained and is able to satisfy the appropriate user’s comfort according to the external conditions for next day. Within the usage range, an optimal scheduling for appliances would be conducted so as to minimize an electricity cost with considering user’s comfort. Among the home appliance, electric heater (EH) is a representative appliance which is affected by the external temperature. In this paper, an optimal scheduling algorithm for an electric heater (EH) is addressed based on the method of branch and bound. As a result, scenarios for the EH usage are obtained according to user’s comfort levels and then the residential consumer would select the best scenario. The case study shows the effects of the proposed algorithm compared with the traditional operation of the EH, and it also represents impacts of the comfort level on the scheduling result.

Keywords: load scheduling, usage pattern, user’s comfort, copula function, branch and bound, electric heater

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44963 Reviewers’ Perception of the Studio Jury System: How They View its Value in Architecture and Design Education

Authors: Diane M. Bender

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In architecture and design education, students learn and understand their discipline through lecture courses and within studios. A studio is where the instructor works closely with students to help them understand design by doing design work. The final jury is the culmination of the studio learning experience. It’s value and significance are rarely questioned. Students present their work before their peers, instructors, and invited reviewers, known as jurors. These jurors are recognized experts who add a breadth of feedback to students mostly in the form of a verbal critique of the work. Since the design review or jury has been a common element of studio education for centuries, jurors themselves have been instructed in this format. Therefore, they understand its value from both a student and a juror perspective. To better understand how these reviewers see the value of a studio review, a survey was distributed to reviewers at a multi-disciplinary design school within the United States. Five design disciplines were involved in this case study: architecture, graphic design, industrial design, interior design, and landscape architecture. Respondents (n=108) provided written comments about their perceived value of the studio review system. The average respondent was male (64%), between 40-49 years of age, and has attained a master’s degree. Qualitative analysis with thematic coding revealed several themes. Reviewers view the final jury as important because it provides a variety of perspectives from unbiased external practitioners and prepares students for similar presentation challenges they will experience in professional practice. They also see it as a way to validate the assessment and evaluation of students by faculty. In addition, they see a personal benefit for themselves and their firm – the ability to network with fellow jurors, professors, and students (i.e., future colleagues). Respondents also provided additional feedback about the jury system and studio education in general. Typical responses included a desire for earlier engagement with students; a better explanation from the instructor about the project parameters, rubrics/grading, and guidelines for juror involvement; a way to balance giving encouraging feedback versus overly critical comments; and providing training for jurors prior to reviews. While this study focused on the studio review, the findings are equally applicable to other disciplines. Suggestions will be provided on how to improve the preparation of guests in the learning process and how their interaction can positively influence student engagement.

Keywords: assessment, design, jury, studio

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44962 The Paradox of Design Aesthetics and the Sustainable Design

Authors: Asena Demirci, Gozen Guner Aktaş, Nur Ayalp

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Nature provides a living space for humans, also in contrast it is destroyed by humans for their personal needs and ambitions. For decreasing these damages against nature, solutions are started to generate and to develop. Moreover, precautions are implemented. After 1960s, especially when the ozone layer got harmed and got thinner by toxic substances coming from man made structures, environmental problems which effected human’s activities of daily living. Thus, this subject about environmental solutions and precautions is becoming a priority issue for scientists. Most of the environmental problems are caused by buildings and factories which are built without any concerns about protecting nature. This situation creates awareness about environmental issues and also the terms like sustainability, Renewable energy show up in building, Construction and architecture sectors to provide environmental protection. In this perspective, the design disciplines also should be respectful to nature and the sustainability. Designs which involve the features like sustainability, renewability and being ecologic have specialties to be less detrimental to the environment rather than the designs which do not involve. Furthermore, these designs produce their own energy for consuming, So they do not use the natural resources. They do not contain harmful substances and they are made of recyclable materials. Thus, they are becoming environmentally friendly structures. There is a common concern among designers about the issue of sustainable design. They believe that the idea of sustainability inhibits the creativity. All works of design resemble each other from the point of aesthetics and technological matters. In addition, there is a concern about design ethics which aesthetic designs cannot be accepted as a priority. For these reasons, there are few designs included the features of being eco-friendly and well-designed and also had design concerns around the world. Despite the other design disciplines, The concept of sustainability is getting more important each day in interior architecture and interior design. As it is known that human being spends 90 % of his life in interior spaces, The importance of that concept in interior spaces is obvious. Aesthetic is another vital concern in interior space design also. Most of the time sustainable materials and sustainable interior design applications conflicts with personal aesthetic parameters. This study aims to discuss the great paradox between the design aesthetic and the sustainable design. Does the sustainable approach in interior design disturbs the design aesthetic? This is one of the most popular questions that have been discussed for a while. With this paper this question will be evaluated with a case study which analyzes the aesthetic perceptions and preferences of the users and designers in sustainable interior spaces.

Keywords: aesthetics, interior design, sustainable design, sustainability

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44961 Effectiveness of Peer Reproductive Health Education Program in Improving Knowledge, Attitude, and Use Health Service of High School Adolescent Girls in Eritrea in 2014

Authors: Ghidey Ghebreyohanes, Eltahir Awad Gasim Khalil, Zemenfes Tsighe, Faiza Ali

Abstract:

Background: reproductive health (RH) is a state of physical, mental and social well-being in all matters relating to the reproductive system at all stages of life. In East Africa including Eritrea, adolescents comprise more than a quarter of the population. The region holds the highest rates of sexually transmitted diseases, HIV, unwanted pregnancy and unsafe abortion with its complications. Young girls carry the highest burden of reproductive health problems due to their risk taking behavior, lack of knowledge, peer pressure, physiologic immaturity and low socioeconomic status. Design: this was a Community-based, randomized, case-controlled and pre-test-post-test intervention study. Setting: Zoba Debub was randomly selected out of the six zobas in Eritrea. The four high schools out of the 26 in Zoba Debub were randomly selected as study target schools. Over three quarter of the people live on farming. The target population was female students attending grade nine with majority of these girls live in the distant villages and walk to school. The study participants were randomly selected (n=165) from each school. Furthermore, the 1 intervention and 3 controls for the study arms were assigned randomly. Objectives: this study aimed to assess the effectiveness of peer reproductive health education in improving knowledge, attitude, and health service use of high school adolescent girls in Eritrea Methods: the protocol was reviewed and approved by the Scientific and Ethics Committees of Faculty of Nursing Sciences, University of Khartoum. Data was collected using pre-designed and pretested questionnaire emphasizing on reproductive health knowledge, attitude and practice. Sample size was calculated using proportion formula (α 0.01; power of 95%). Measures used were scores and proportions. Descriptive and inferential statistics, t-test and chi square at (α .01), 99% confidence interval were used to compare changes of pre and post-intervention scores using SPSS soft ware. Seventeen students were selected for peer educators by the school principals and other teachers based on inclusion criteria that include: good academic performance and acceptable behavior. One peer educator educated one group composed of 8-10 students for two months. One faculty member was selected to supervise peer educators. The principal investigator conducted the training of trainers and provided supervision and discussion to peer educators every two weeks until the end of intervention. Results: following informed consent, 627 students [164 in intervention and 463 in the control group] with a ratio of 1 to 3, were enrolled in the study. The mean age for the total study population was 15.4±1.0 years. The intervention group mean age was 15.3±1.0 year; while the control group had a mean age of 15.4±1.0. The mean ages for the study arms were similar (p= 0.4). The majority (96 %) of the study participants are from Tigrigna ethnic group. Reproductive knowledge scores which was calculated out of a total 61 grade points: intervention group (pretest 6.7 %, post-test 33.6 %; p= 0.0001); control group (pretest 7.3 %, posttest 7.3 %, p= 0.92). Proportion difference in attitude calculated out of 100%: intervention group (pretest 42.3 % post test 54.7% p= 0.001); controls group (pretest 45%, post test 44.8 p= 0.7). Proportion difference in Practice calculated out of 100 %: intervention group (pretest 15.4%, post test 80.4 % p= 0.0001); control group (pretest 16.8%, posttest 16.9 % p= 0.8). Mothers were quoted as major (> 90 %) source of reproductive health information. All focus group discussants and most of survey participants agreed on the urgent need of reproductive health information and services for adolescent girls. Conclusion: reproductive health knowledge and use of facilities is poor among adolescent girls in sub-urban Eretria. School-based peer reproductive health education is effective and is the best strategy to improve reproductive health knowledge and attitudes.

Keywords: reproductive health, adolescent girls, eretria, health education

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