Search results for: macroeconomic factors
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 10773

Search results for: macroeconomic factors

2973 Influence of Reinforcement Stiffness on the Performance of Back-to-Back Reinforced Earth Wall upon Rainwater Infiltration

Authors: Gopika Rajagopal, Sudheesh Thiyyakkandi

Abstract:

Back-to-back reinforced earth (RE) walls are extensively used in these days as bridge abutments and highway ramps, owing to their cost efficiency and ease of construction. High quality select fill is the most suitable backfill material due to its excellent engineering properties and constructability. However, industries are compelled to use low quality, locally available soil because of its ample availability on site. However, several failure cases of such walls are reported, especially subsequent to rainfall events. The stiffness of reinforcement is one of the major factors affecting the performance of RE walls. The present study focused on analyzing the effect of reinforcement stiffness on the performance of complete select fill, complete marginal fill, and hybrid-fill (i.e., combination of select and marginal fills) back-to-back RE walls, immediately after construction and upon rainwater infiltration through finite element modelling. A constant width to height (W/H) ratio of 3 and height (H) of 6 m was considered for the numerical analysis and the stiffness of reinforcement layers was varied from 500 kN/m to 10000 kN/m. Results showed that reinforcement stiffness had a noticeable influence on the response of RE wall, subsequent to construction as well as rainwater infiltration. Facing displacement was found to decrease and maximum reinforcement tension and factor of safety were observed to increase with increasing the stiffness of reinforcement. However, beyond a stiffness of 5000 kN/m, no significant reduction in facing displacement was observed. The behavior of fully marginal fill wall considered in this study was found to be reasonable even after rainwater infiltration when the high stiffness reinforcement layers are used.

Keywords: back-to-back reinforced earth wall, finite element modelling, rainwater infiltration, reinforcement stiffness

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2972 Relationship Between tcdA and tcdB Genes of Clostridium difficile with Duration of Diarrhea in Elderly Patients

Authors: Ni Luh Putu Harta Wedari

Abstract:

Background: Clostridium difficile has two main virulence factors, namely TcdA and TcdB. TcdA encoded by the tcdA gene acts as an enterotoxin, pro-inflammatory and fluid accumulation, while TcdB encoded by the tcdB gene is cytotoxic, causes disruption of the actin cytoskeleton, and causes disruption of tight junctions in colon cells. This study aims to explore the relationship between the tcdA and tcdB genes and the duration of diarrhea in elderly patients. Method: This research was an observational analytic with a prospective cross-sectional with samples of elderly diarrhea patients who met the inclusion criteria in Denpasar City health service facilities from 1 December 2022 until 30 June 2023, and then their feces were analyzed using the real-time PCR method. Results: In this study, 40 elderly diarrhea patients met the inclusion criteria and in accordance with the minimum sample size, 28 (70%) men and 12 (30%) women. 5 patients (12.5%) had a history of azithromycin, 4 (10%) levofloxacin, 17 (42.5%) ciprofloxacin, 8 (20%) metronidazole, 1 (2.5%) cefoperazone, 5 (12, 5%) doxycycline. Comorbids, namely 13 (32.5%) type II diabetes mellitus, 4 (10%) chronic kidney disease, 10 (25%) malignancies, 7 (17.5%) urinary tract infections, 3 (7.5%) %) immunocompromised, 2 (5%) cardiac heart failure, and 1 (2.5%) acute on chronic kidney disease. The overall diarrhea duration average was 5 days. 8 samples (20%) were positive for 16s rRNA, and there was no significant difference in diarrhea duration with negative samples (p=0.166). The relationship between the tcdA gene and the duration of diarrhea could not be performed because all samples were negative. Likewise, relationship analysis between the coexistence of tcdA and tcdB could not be performed. There was no significant difference between tcdB positive 3 (7.5%) and negative with diarrhea duration (p=0.739). Conclusion: There is no significant relationship between the presence of the 16s rRNA and tcdB C. difficile genes with the duration of diarrhea in elderly patients.

Keywords: clostridium, difficile, diarrhea, elderly, tcdA, tcdB

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2971 An In-Depth Experimental Study of Wax Deposition in Pipelines

Authors: Arias M. L., D’Adamo J., Novosad M. N., Raffo P. A., Burbridge H. P., Artana G.

Abstract:

Shale oils are highly paraffinic and, consequently, can create wax deposits that foul pipelines during transportation. Several factors must be considered when designing pipelines or treatment programs that prevents wax deposition: including chemical species in crude oils, flowrates, pipes diameters and temperature. This paper describes the wax deposition study carried out within the framework of Y-TEC's flow assurance projects, as part of the process to achieve a better understanding on wax deposition issues. Laboratory experiments were performed on a medium size, 1 inch diameter, wax deposition loop of 15 mts long equipped with a solid detector system, online microscope to visualize crystals, temperature and pressure sensors along the loop pipe. A baseline test was performed with diesel with no paraffin or additive content. Tests were undertaken with different temperatures of circulating and cooling fluid at different flow conditions. Then, a solution formed with a paraffin added to the diesel was considered. Tests varying flowrate and cooling rate were again run. Viscosity, density, WAT (Wax Appearance Temperature) with DSC (Differential Scanning Calorimetry), pour point and cold finger measurements were carried out to determine physical properties of the working fluids. The results obtained in the loop were analyzed through momentum balance and heat transfer models. To determine possible paraffin deposition scenarios temperature and pressure loop output signals were studied. They were compared with WAT static laboratory methods. Finally, we scrutinized the effect of adding a chemical inhibitor to the working fluid on the dynamics of the process of wax deposition in the loop.

Keywords: paraffin desposition, flow assurance, chemical inhibitors, flow loop

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2970 A Neuroscience-Based Learning Technique: Framework and Application to STEM

Authors: Dante J. Dorantes-González, Aldrin Balsa-Yepes

Abstract:

Existing learning techniques such as problem-based learning, project-based learning, or case study learning are learning techniques that focus mainly on technical details, but give no specific guidelines on learner’s experience and emotional learning aspects such as arousal salience and valence, being emotional states important factors affecting engagement and retention. Some approaches involving emotion in educational settings, such as social and emotional learning, lack neuroscientific rigorousness and use of specific neurobiological mechanisms. On the other hand, neurobiology approaches lack educational applicability. And educational approaches mainly focus on cognitive aspects and disregard conditioning learning. First, authors start explaining the reasons why it is hard to learn thoughtfully, then they use the method of neurobiological mapping to track the main limbic system functions, such as the reward circuit, and its relations with perception, memories, motivations, sympathetic and parasympathetic reactions, and sensations, as well as the brain cortex. The authors conclude explaining the major finding: The mechanisms of nonconscious learning and the triggers that guarantee long-term memory potentiation. Afterward, the educational framework for practical application and the instructors’ guidelines are established. An implementation example in engineering education is given, namely, the study of tuned-mass dampers for earthquake oscillations attenuation in skyscrapers. This work represents an original learning technique based on nonconscious learning mechanisms to enhance long-term memories that complement existing cognitive learning methods.

Keywords: emotion, emotion-enhanced memory, learning technique, STEM

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2969 Optimizing Nitrogen Fertilizer Application in Rice Cultivation: A Decision Model for Top and Ear Dressing Dosages

Authors: Ya-Li Tsai

Abstract:

Nitrogen is a vital element crucial for crop growth, significantly influencing crop yield. In rice cultivation, farmers often apply substantial nitrogen fertilizer to maximize yields. However, excessive nitrogen application increases the risk of lodging and pest infestation, leading to yield losses. Additionally, conventional flooded irrigation methods consume significant water resources, necessitating precise agricultural and intelligent water management systems. In this study, it leveraged physiological data and field images captured by unmanned aerial vehicles, considering fertilizer treatment and irrigation as key factors. Statistical models incorporating rice physiological data, yield, and vegetation indices from image data were developed. Missing physiological data were addressed using multiple imputation and regression methods, and regression models were established using principal component analysis and stepwise regression. Target nitrogen accumulation at key growth stages was identified to optimize fertilizer application, with the difference between actual and target nitrogen accumulation guiding recommendations for ear dressing dosage. Field experiments conducted in 2022 validated the recommended ear dressing dosage, demonstrating no significant difference in final yield compared to traditional fertilizer levels under alternate wetting and drying irrigation. These findings highlight the efficacy of applying recommended dosages based on fertilizer decision models, offering the potential for reduced fertilizer use while maintaining yield in rice cultivation.

Keywords: intelligent fertilizer management, nitrogen top and ear dressing fertilizer, rice, yield optimization

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2968 Usability Evaluation of Rice Doctor as a Diagnostic Tool for Agricultural Extension Workers in Selected Areas in the Philippines

Authors: Jerome Cayton Barradas, Rowely Parico, Lauro Atienza, Poornima Shankar

Abstract:

The effective agricultural extension is essential in facilitating improvements in various agricultural areas. One way of doing this is through Information and communication technologies (ICTs) like Rice Doctor (RD), an app-based diagnostic tool that provides accurate and timely diagnosis and management recommendations for more than 80 crop problems. This study aims to evaluate the RD usability by determining the effectiveness, efficiency, and user satisfaction of RD in making an accurate and timely diagnosis. It also aims to identify other factors that affect RD usability. This will be done by comparing RD with two other diagnostic methods: visual identification-based diagnosis and reference-guided diagnosis. The study was implemented in three rice-producing areas and has involved 96 extension workers. Respondents accomplished a self-administered survey and participated in group discussions. Data collected was then subjected to qualitative and quantitative analysis. Most of the respondents were satisfied with RD and believed that references are needed in assuring the accuracy of diagnosis. The majority found it efficient and easy to use. Some found it confusing and complicated, but this is because of their unfamiliarity with RD. Most users were also able to achieve accurate diagnosis proving effectiveness. Lastly, although users have reservations, they are satisfied and open to using RD. The study also found out the importance of visual identification skills in using RD and the need for capacity development and improvement of access to RD devices. From these results, the following are recommended to improve RD usability: review and upgrade diagnostic keys, expand further RD content, initiate capacity development for AEWs, and prepare and implement an RD communication plan.

Keywords: agricultural extension, crop protection, information and communication technologies, rice doctor

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2967 EMS Providers' Ability and Willingness to Respond to Bioterrorism

Authors: Ryan Houser

Abstract:

Introduction: Previous studies have found that public health systems within the United States are inadequately prepared for an act of biological terrorism. As the COVID-19 pandemic continues, few studies have evaluated bioterrorism preparedness of Emergency Medical Services, even in the accelerating environment of biothreats. Methods: This study utilized an Internet-based survey to assess the level of preparedness and willingness to respond to a bioterrorism attack and identify factors that predict preparedness and willingness among Nebraska EMS (Emergency Medical Services ) providers. The survey was available for one month in 2021, during which 190 EMS providers responded to the survey. Results: Only 56.8% of providers were able to recognize an illness or injury as potentially resulting from exposure to a CBRN agent. The provider Clinical Competency levels range from a low of 13.6% (ability to initiate patient care within his/her professional scope of practice and arrange for prompt referral appropriate to the identified condition(s)) to a high of 74% (the ability to respond to an emergency within the emergency management system of his/her practice, institution and community). Only 10% of the respondents are both willing and able to effectively function in a bioterror environment. Discussion: In order to effectively prepare for and respond to a bioterrorist attack, all levels of the healthcare system need to have the clinical skills, knowledge, and abilities necessary to treat patients exposed. Policy changes and increased focus on training and drills are needed to ensure a prepared EMS system which is crucial to a resilient state. EMS entities need to be aware of the extent of their available workforce so that the country can be prepared for the increasing threat of bioterrorism or other novel emerging infectious disease outbreaks. A resilient nation relies on a prepared set of EMS providers who are willing to respond to biological terrorism events.

Keywords: bioterrorism, prehospital, EMS, disaster, emergency, medicine, preparedness, policy

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2966 Tokyo Skyscrapers: Technologically Advanced Structures in Seismic Areas

Authors: J. Szolomicki, H. Golasz-Szolomicka

Abstract:

The architectural and structural analysis of selected high-rise buildings in Tokyo is presented in this paper. The capital of Japan is the most densely populated city in the world and moreover is located in one of the most active seismic zones. The combination of these factors has resulted in the creation of sophisticated designs and innovative engineering solutions, especially in the field of design and construction of high-rise buildings. The foreign architectural studios (as, for Jean Nouvel, Kohn Pedesen Associates, Skidmore, Owings & Merill) which specialize in the designing of skyscrapers, played a major role in the development of technological ideas and architectural forms for such extraordinary engineering structures. Among the projects completed by them, there are examples of high-rise buildings that set precedents for future development. An essential aspect which influences the design of high-rise buildings is the necessity to take into consideration their dynamic reaction to earthquakes and counteracting wind vortices. The need to control motions of these buildings, induced by the force coming from earthquakes and wind, led to the development of various methods and devices for dissipating energy which occur during such phenomena. Currently, Japan is a global leader in seismic technologies which safeguard seismic influence on high-rise structures. Due to these achievements the most modern skyscrapers in Tokyo are able to withstand earthquakes with a magnitude of over seven degrees at the Richter scale. Damping devices applied are of a passive, which do not require additional power supply or active one which suppresses the reaction with the input of extra energy. In recent years also hybrid dampers were used, with an additional active element to improve the efficiency of passive damping.

Keywords: core structures, damping system, high-rise building, seismic zone

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2965 The Prodomain-Bound Form of Bone Morphogenetic Protein 10 is Biologically Active on Endothelial Cells

Authors: Austin Jiang, Richard M. Salmon, Nicholas W. Morrell, Wei Li

Abstract:

BMP10 is highly expressed in the developing heart and plays essential roles in cardiogenesis. BMP10 deletion in mice results in embryonic lethality due to impaired cardiac development. In adults, BMP10 expression is restricted to the right atrium, though ventricular hypertrophy is accompanied by increased BMP10 expression in a rat hypertension model. However, reports of BMP10 activity in the circulation are inconclusive. In particular it is not known whether in vivo secreted BMP10 is active or whether additional factors are required to achieve its bioactivity. It has been shown that high-affinity binding of the BMP10 prodomain to the mature ligand inhibits BMP10 signaling activity in C2C12 cells, and it was proposed that prodomain-bound BMP10 (pBMP10) complex is latent. In this study, we demonstrated that the BMP10 prodomain did not inhibit BMP10 signaling activity in multiple endothelial cells, and that recombinant human pBMP10 complex, expressed in mammalian cells and purified under native conditions, was fully active. In addition, both BMP10 in human plasma and BMP10 secreted from the mouse right atrium were fully active. Finally, we confirmed that active BMP10 secreted from mouse right atrium was in the prodomain-bound form. Our data suggest that circulating BMP10 in adults is fully active and that the reported vascular quiescence function of BMP10 in vivo is due to the direct activity of pBMP10 and does not require an additional activation step. Moreover, being an active ligand, recombinant pBMP10 may have therapeutic potential as an endothelial-selective BMP ligand, in conditions characterized by loss of BMP9/10 signaling.

Keywords: bone morphogenetic protein 10 (BMP10), endothelial cell, signal transduction, transforming growth factor beta (TGF-B)

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2964 History of Recurrent Mucosal Infections and Immune System Disorders Is Related to Complications of Non-infectious Anterior Uveitis

Authors: Barbara Torres Rives

Abstract:

Uveitis. Non-infectious anterior uveitis is a polygenic inflammatory eye disease, and it is suggested that mediated processes by the immune system (autoimmune or not) are the main mechanisms proposed in the pathogenesis of this type of uveitis. A relationship between infectious processes, digestive disorders, and a dysbiosis of the microbiome was recently described. In addition, alterations in the immune response associated with the initiation and progression of the disease have been described. Objective: The aim of this study was to identify factors related to the immune system associated with complicated non-infectious anterior uveitis. Methods: A cross-sectional observational analytical study was carried out. The universe consisted of all patients attending the ocular inflammation service of the Cuban Institute of Ophthalmology Ramón Pando Ferrer. The sample consisted of 213 patients diagnosed with non-infectious anterior uveitis. Results: Of the 213 patients with non-infectious anterior uveitis, the development of ophthalmologic complications predominated 56.3% (p=0.0094). In patients with complications was more frequent the presence of human leukocyte antigen-B27 allele (49.2%) (p<0.0001), decreased immunoglobulin G (24.2%, p=0.0124), increased immunoglobulin A (14.2%, p=0.0024), history of recurrent sepsis (59.2%, p=0.0018), recurrent respiratory infections (44.2%, p=0.0003), digestive alterations (40%, p=0.0013) and spondyloarthropathies (30%, p=0.0314). By logistic regression, it was observed that, for each completed year, the elevated risk for developing complicated non-infectious anterior uveitis in human leukocyte antigen-B27 allele positive patients (OR: 4.22, p=0.000), Conclusions: The control of recurrent sepsis at mucosal level and immunomodulation could prevent complications in non-infectious anterior uveitis. Therefore, the microbiome becomes the target of treatment and prevention of complications in non-infectious anterior uveitis.

Keywords: non-infectious anterior uveitis, immune system disorders, recurrent mucosal infections, microbiome

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2963 An Experimental Approach to the Influence of Tipping Points and Scientific Uncertainties in the Success of International Fisheries Management

Authors: Jules Selles

Abstract:

The Atlantic and Mediterranean bluefin tuna fishery have been considered as the archetype of an overfished and mismanaged fishery. This crisis has demonstrated the role of public awareness and the importance of the interactions between science and management about scientific uncertainties. This work aims at investigating the policy making process associated with a regional fisheries management organization. We propose a contextualized computer-based experimental approach, in order to explore the effects of key factors on the cooperation process in a complex straddling stock management setting. Namely, we analyze the effects of the introduction of a socio-economic tipping point and the uncertainty surrounding the estimation of the resource level. Our approach is based on a Gordon-Schaefer bio-economic model which explicitly represents the decision making process. Each participant plays the role of a stakeholder of ICCAT and represents a coalition of fishing nations involved in the fishery and decide unilaterally a harvest policy for the coming year. The context of the experiment induces the incentives for exploitation and collaboration to achieve common sustainable harvest plans at the Atlantic bluefin tuna stock scale. Our rigorous framework allows testing how stakeholders who plan the exploitation of a fish stock (a common pool resource) respond to two kinds of effects: i) the inclusion of a drastic shift in the management constraints (beyond a socio-economic tipping point) and ii) an increasing uncertainty in the scientific estimation of the resource level.

Keywords: economic experiment, fisheries management, game theory, policy making, Atlantic Bluefin tuna

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2962 Assessment of Arterial Stiffness through Measurement of Magnetic Flux Disturbance and Electrocardiogram Signal

Authors: Jing Niu, Jun X. Wang

Abstract:

Arterial stiffness predicts mortality and morbidity, independently of other cardiovascular risk factors. And it is a major risk factor for age-related morbidity and mortality. The non-invasive industry gold standard measurement system of arterial stiffness utilizes pulse wave velocity method. However, the desktop device is expensive and requires trained professional to operate. The main objective of this research is the proof of concept of the proposed non-invasive method which uses measurement of magnetic flux disturbance and electrocardiogram (ECG) signal for measuring arterial stiffness. The method could enable accurate and easy self-assessment of arterial stiffness at home, and to help doctors in research, diagnostic and prescription in hospitals and clinics. A platform for assessing arterial stiffness through acquisition and analysis of radial artery pulse waveform and ECG signal has been developed based on the proposed method. Radial artery pulse waveform is acquired using the magnetic based sensing technology, while ECG signal is acquired using two dry contact single arm ECG electrodes. The measurement only requires the participant to wear a wrist strap and an arm band. Participants were recruited for data collection using both the developed platform and the industry gold standard system. The results from both systems underwent correlation assessment analysis. A strong positive correlation between the results of the two systems is observed. This study presents the possibility of developing an accurate, easy to use and affordable measurement device for arterial stiffness assessment.

Keywords: arterial stiffness, electrocardiogram, pulse wave velocity, Magnetic Flux Disturbance

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2961 A Comparative Analysis of (De)legitimation Strategies in Selected African Inaugural Speeches

Authors: Lily Chimuanya, Ehioghae Esther

Abstract:

Language, a versatile and sophisticated tool, is fundamentally sacrosanct to mankind especially within the realm of politics. In this dynamic world, political leaders adroitly use language to engage in a strategic show aimed at manipulating or mechanising the opinion of discerning people. This nuanced synergy is marked by different rhetorical strategies, meticulously synced with contextual factors ranging from cultural, ideological, and political to achieve multifaceted persuasive objectives. This study investigates the (de)legitimation strategies inherent in African presidential inaugural speeches, as African leaders not only state their policy agenda through inaugural speeches but also subtly indulge in a dance of legitimation and delegitimation, performing a twofold objective of strengthening the credibility of their administration and, at times, undermining the performance of the past administration. Drawing insights from two different legitimation models and a dataset of 4 African presidential inaugural speeches obtained from authentic websites, the study describes the roles of authorisation, rationalisation, moral evaluation, altruism, and mythopoesis in unmasking the structure of political discourse. The analysis takes a mixed-method approach to unpack the (de)legitimation strategy embedded in the carefully chosen speeches. The focus extends beyond a superficial exploration and delves into the linguistic elements that form the basis of presidential discourse. In conclusion, this examination goes beyond the nuanced landscape of language as a potent tool in politics, with each strategy contributing to the overall rhetorical impact and shaping the narrative. From this perspective, the study argues that presidential inaugural speeches are not only linguistic exercises but also viable weapons that influence perceptions and legitimise authority.

Keywords: CDA, legitimation, inaugural speeches, delegitmation

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2960 Research on Community-Based Engineering Learning and Undergraduate Students’ Creativity in China: The Moderate Effect of Engineering Identity

Authors: Liang Wang, Wei Zhang

Abstract:

There have been some existing researches on design-based engineering learning (DBEL) and project-based or problem-based engineering learning (PBEL). Those findings have greatly promoted the reform of engineering education in China. However, the engineering with a big E means that more and more engineering activities are designed and operated by communities of practice (CoPs), namely community-based engineering learning. However, whether community-based engineering learning can promote students' innovation has not been verified in published articles. This study fills this gap by investigating the relationship between community-based learning approach and students’ creativity, using engineering identity as an intermediary variable. The goal of this study is to discover the core features of community-based engineering learning, and make the features more beneficial for students’ creativity. The study created and adapted open survey items from previously published studies and a scale on learning community, students’ creativity and engineering identity. Firstly, qualitative content analysis methods by MAXQDA were used to analyze 32 open-ended questionnaires. Then the authors collected data (n=322) from undergraduate students in engineering competition teams and engineering laboratories in Zhejiang University, and structural equation modelling (SEM) was used to understand the relationship between different factors. The study finds: (a) community-based engineering learning has four main elements like real-task context, self-inquiry learning, deeply-consulted cooperation and circularly-iterated design, (b) community-based engineering learning can significantly enhance the engineering undergraduate students’ creativity, and (c) engineering identity partially moderated the relationship between community-based engineering learning and undergraduate students' creativity. The findings further illustrate the value of community-based engineering learning for undergraduate students. In the future research, the authors should further clarify the core mechanism of community-based engineering learning, and pay attention to the cultivation of undergraduate students’ engineer identity in learning community.

Keywords: community-based engineering learning, students' creativity, engineering identity, moderate effect

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2959 Effect of Aging Time and Mass Concentration on the Rheological Behavior of Vase of Dam

Authors: Hammadi Larbi

Abstract:

Water erosion, the main cause of the siltation of a dam, is a natural phenomenon governed by natural physical factors such as aggressiveness, climate change, topography, lithology, and vegetation cover. Currently, a vase from certain dams is released downstream of the dikes during devastation by hydraulic means. The vases are characterized by complex rheological behaviors: rheofluidification, yield stress, plasticity, and thixotropy. In this work, we studied the effect of the aging time of the vase in the dam and the mass concentration of the vase on the flow behavior of a vase from the Fergoug dam located in the Mascara region. In order to test the reproducibility of results, two replicates were performed for most of the experiments. The flow behavior of the vase studied as a function of storage time and mass concentration is analyzed by the Herschel Bulkey model. The increase in the aging time of the vase in the dam causes an increase in the yield stress and the consistency index of the vase. This phenomenon can be explained by the adsorption of the water by the vase and the increase in volume by swelling, which modifies the rheological parameters of the vase. The increase in the mass concentration in the vase leads to an increase in the yield stress and the consistency index as a function of the concentration. This behavior could be explained by interactions between the granules of the vase suspension. On the other hand, the increase in the aging time and the mass concentration of the vase in the dam causes a reduction in the flow index of the vase. The study also showed an exponential decrease in apparent viscosity with the increase in the aging time of the vase in the dam. If a vase is allowed to age long enough for the yield stress to be close to infinity, its apparent viscosity is also close to infinity; then the apparent viscosity also tends towards infinity; this can, for example, subsequently pose problems when dredging dams. For good dam management, it could be then deduced to reduce the dredging time of the dams as much as possible.

Keywords: vase of dam, aging time, rheological behavior, yield stress, apparent viscosity, thixotropy

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2958 Land Use Planning Tool to Achieve Land Degradation Neutrality: Tunisia Case Study

Authors: Rafla Attia, Claudio Zucca, Bao Quang Le, Sana Dridi, Thouraya Sahli, Taoufik Hermassi

Abstract:

In Tunisia, landscape change and land degradation are critical issues for landscape conservation, management, and planning. Landscapes are undergoing crucial environmental problems made evident by soil degradation and desertification. Human improper uses of land resources (e.g., unsuitable land uses, unsustainable crop intensification, and poor rangeland management) and climate change are the main factors leading to the landscape transformation and desertification affecting high proportions of the Tunisian lands. Land use planning (LUP) to achieve Land Degradation Neutrality (LDN) must be supported by methodologies and technologies that help identify best solutions and practices and design context-specific sustainable land management (SLM) strategies. Such strategies must include restoration or rehabilitation efforts in areas with high land degradation, as well as prevention of degradation that could be caused by improper land use (LU) and land management (LM). The geoinformatics Land Use Planning for LDN (LUP4LDN) tool has been designed for this purpose. Its aim is to support national and sub-national planners in i) mapping geographic patterns of current land degradation; ii) anticipating further future land degradation expected in areas that are unsustainably managed; and iii) providing an interactive procedure for developing participatory LU-LM transitional scenarios over selected regions of interest and timeframes, visualizing the related expected levels of impacts on ecosystem services via maps and graphs. The tool has been co-developed and piloted with national stakeholders in Tunisia. The piloting implementation assessed how the LUP4LDN tool fits with existing LUP processes and the benefits achieved by using the tool to support land use planning for LDN.

Keywords: land use system, land cover, sustainable land management, land use planning for land degradation neutrality

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2957 Mental Disorders and Physical Illness in Geriatric Population

Authors: Vinay Kumar, M. Kishor, Sathyanarayana Rao Ts

Abstract:

Background: Growth of elderly people in the general population in recent years is termed as ‘greying of the world’ where there is a shift from high mortality & fertility to low mortality and fertility, resulting in an increased proportion of older people as seen in India. Improved health care promises longevity but socio-economic factors like poverty, joint families and poor services pose a psychological threat. Epidemiological data regarding the prevalence of mental disorders in geriatric population with physical illness is required for proper health planning. Methods: Sixty consecutive elderly patients aged 60 years or above of both sexes, reporting with physical illness to general outpatient registration counter of JSS Medical College and Hospital, Mysore, India, were considered for the Study. With informed consent, they were screened with General Health Questionnaire (GHQ-12) and were further evaluated for diagnosing mental disorders according to WHO International Classification of Diseases (ICD-10) criteria. Results: Mental disorders were detected in 48.3%, predominantly depressive disorders, nicotine dependence, generalized anxiety disorder, alcohol dependence and least was dementia. Most common physical illness was cardiovascular disease followed by metabolic, respiratory and other diseases. Depressive disorders, substance dependence and dementia were more associated with cardiovascular disease compared to metabolic disease and respiratory diseases were more associated with nicotine dependence. Conclusions: Depression and Substance use disorders among elderly population is of concern, which needs to be further studied with larger population. Psychiatric morbidity will adversely have an impact on physical illness which needs proper assessment and management. This will enhance our understanding and prioritize our planning for future.

Keywords: Geriatric, mental disorders, physical illness, psychiatry

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2956 Application of Non-Smoking Areas in Hospitals

Authors: Nur Inayah Ismaniar, Sukri Palutturi, Ansariadi, Atjo Wahyu

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Background: In various countries in the world, the problem of smoking is now considered something serious because of the effects of smoking which can not only lead to addiction but also have the potential to harm health. Public health authorities have concluded that one solution that can be done to protect the public from active smokers is to issue a policy that requires public facilities to be completely smoke-free. The hospital is one of the public facilities that has been designated as a smoke-free area. However, the implementation and maintenance of a successful program based on a smoke-free hospital are still considered an ongoing challenge worldwide due to the very low level of adherence. The low level of compliance with this smoke-free policy is also seen in other public facilities. The purpose of the literature review is to review the level of compliance with the application of the Non-Smoking Area policy, how this policy has succeeded in reducing smoking activity in hospitals, and what factors lead to such compliance in each country in the world. Methods: A literature review of articles was carried out on all types of research methods, both qualitative and quantitative. The sample is all subjects who are in the research location, which includes patients, staff and hospital visitors. Results: Various variations in the level of compliance were found in various kinds of literature. The literature with the highest level of compliance is 88.4%. Furthermore, several determinants that are known to affect the compliance of the Non-Smoking Area policies in hospitals include communication, information, knowledge, perceptions, interventions, attitudes and support. Obstacles to its enforcement are the absence of sanctions against violators of the Non-Smoking Area policy, the ineffectiveness of the function of policymakers in hospitals, and negative perceptions of smoking related to mental health. Conclusion: Violations of the Non-Smoking Area policy are often committed by the hospital staff themselves, which makes it difficult for this policy to be fully enforced at various points in the hospital.

Keywords: health policy, non-smoking area, hospital, implementation

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2955 Heritage of the Ancient Greco-Roman Cities and Harbors in the North West Coast of Egypt

Authors: Wessam Fekry Ibrahim Moussa

Abstract:

The northwest coast of Egypt embraces about 500 km of the Mediterranean coastline. The area covered extends from Alexandria on the East to the village of Sallum at Egypt's border with Libya in the west with an average depth of 20-70 km. When one looks at this long strip of land, one is struck by the fact that, from the archaeological point of view, one knows relatively little about this region during ancient times, its history, villages, inhabitants, and heritage. According to classical writers, in antiquity, the area seemed to be more populated and characterized by its rich buildings and inhabitants. They mentioned several Greco-Roman towns and harbors scattered along the coast nearly 2 thousand years ago. Strabo, for instance, in his book 17, confirmed the existence of about 12 several clusters along the coast, which varied between cities, villages, harbors, and small islands. Claudius Ptolemaeus also enumerated many marina sites as well as some small cities and villages. Unfortunately, nowadays, most of them have been lost either due to the extensive development of the north coast, Natural Disasters, or Erosion Factors. However, recent excavations carried out within the area revealed just a little of these settlements. The aim of this study is to reveal the secrets of the hidden heritage of those ancient sites and shed light on the role they played in the past, as some of them used to be stops on the trade route between Libya and Egypt (Strabo 17) or major centers for some of the international imports. The study will explore the archeological evidence using the analytical methodology to analyze each site and identify its features and significances in order to conclude the importance and role it once played during the past. Findings could be used by authorities and policymakers to utilize these heritage resources to improve cultural tourism within the area and enhance the tourist's experience.

Keywords: Greco Roman, heritage, ancient cities, north west coast

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2954 Tourist’s Perception and Identification of Landscape Elements of Traditional Village

Authors: Mengxin Feng, Feng Xu, Zhiyong Lai

Abstract:

As a typical representative of the countryside, traditional Chinese villages are rich in cultural landscape resources and historical information, but they are still in continuous decline. The problems of people's weak protection awareness and low cultural recognition are still serious, and the protection of cultural heritage is imminent. At the same time, with the rapid development of rural tourism, its cultural value has been explored and paid attention to again. From the perspective of tourists, this study aimed to explore people's perception and identity of cultural landscape resources under the current cultural tourism development background. We selected eleven typical landscape elements of Lingshui Village, a traditional village in Beijing, as research objects and conducted a questionnaire survey with two scales of perception and identity to explore the characteristics of people's perception and identification of landscape elements. We found that there was a strong positive correlation between the perception and identity of each element and that geographical location influenced visitors' overall perception. The perception dimensions scored the highest in location, and the lowest in history and culture, and the identity dimensions scored the highest in meaning and lowest in emotion. We analyzed the impact of visitors' backgrounds on people's perception and identity characteristics and found that age and education were two important factors. The elderly had a higher degree of perceived identity, as the familiarity effect increased their attention. Highly educated tourists had more stringent criteria for perception and identification. The above findings suggest strategies for conserving and optimizing landscape elements in the traditional village to improve the acceptance and recognition of cultural information in traditional villages, which will inject new vitality into the development of traditional villages.

Keywords: traditional village, tourist perception, landscape elements, perception and identity

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2953 Ratio Energy and Protein of Dietary Based on Rice Straw Ammoniated on Productivity of Male Simenthal Cattle

Authors: Mardiati Zain, Yetti Marlida, Elihasridas Elihasridas, Erpomen Erpomen, Andri Andri

Abstract:

Background: Livestock productivity is greatly influenced by the energy and protein balance in diet. This study aimed to determine the energy and protein balance of male Simenthal cattle diet with protein and energy levels. The experimental design used was a randomized block design (RBD) 2x3x3 factorial design. There are two factors namely A level of energy diet that is 65% and 70% TDN. Factor B is a protein level of diet used were 10, 12 and 14% and each treatment is repeated three times. The weight of Simenthal cattle used ranged between 240 - 300 kg. Diet consisted of ammoniated rice straw and concentrated with ratio 40:60. Concentrate consisted of palm kernel cake, rice brain, cassava, mineral, and urea. The variables measured were digestibility of dry matter, organic matter and fiber, dry matter intake, daily gain, feed efficiency and blood characteristic. Results: There was no interaction between protein and energy level of diet on the nutrients intake (DM intake, OM intake, CP intake), weight gain and efficiency (P < 0.01). There was an interaction between protein and energy level of diet on digestibility (DM, OM, CP and allantoin urine (P > 0.01) Nutrients intake decreases with increasing levels of energy and protein diet, while nutrient digestibility, Avarage daily gain and feed efficiency increases with increasing levels of energy and protein diet. Conclusions: The result can be concluded that the best treatment was A2B1 which is energy level 70% TDN and protein 10%, where are dry matter intake 7.66 kg/d, daily gain 1.25 kg/d, feed efficiency 16.12%, and dry matter and organic matter digestibility 64.08 and 69.42% respectively.

Keywords: energy and protein ratio, simenthal cattle, rice straw ammoniated, digestibility

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2952 Trinary Affinity—Mathematic Verification and Application (1): Construction of Formulas for the Composite and Prime Numbers

Authors: Liang Ming Zhong, Yu Zhong, Wen Zhong, Fei Fei Yin

Abstract:

Trinary affinity is a description of existence: every object exists as it is known and spoken of, in a system of 2 differences (denoted dif1, dif₂) and 1 similarity (Sim), equivalently expressed as dif₁ / Sim / dif₂ and kn / 0 / tkn (kn = the known, tkn = the 'to be known', 0 = the zero point of knowing). They are mathematically verified and illustrated in this paper by the arrangement of all integers onto 3 columns, where each number exists as a difference in relation to another number as another difference, and the 2 difs as arbitrated by a third number as the Sim, resulting in a trinary affinity or trinity of 3 numbers, of which one is the known, the other the 'to be known', and the third the zero (0) from which both the kn and tkn are measured and specified. Consequently, any number is horizontally specified either as 3n, or as '3n – 1' or '3n + 1', and vertically as 'Cn + c', so that any number seems to occur at the intersection of its X and Y axes and represented by its X and Y coordinates, as any point on Earth’s surface by its latitude and longitude. Technically, i) primes are viewed and treated as progenitors, and composites as descending from them, forming families of composites, each capable of being measured and specified from its own zero called in this paper the realistic zero (denoted 0r, as contrasted to the mathematic zero, 0m), which corresponds to the constant c, and the nature of which separates the composite and prime numbers, and ii) any number is considered as having a magnitude as well as a position, so that a number is verified as a prime first by referring to its descriptive formula and then by making sure that no composite number can possibly occur on its position, by dividing it with factors provided by the composite number formulas. The paper consists of 3 parts: 1) a brief explanation of the trinary affinity of things, 2) the 8 formulas that represent ALL the primes, and 3) families of composite numbers, each represented by a formula. A composite number family is described as 3n + f₁‧f₂. Since there are an infinitely large number of composite number families, to verify the primality of a great probable prime, we have to have it divided with several or many a f₁ from a range of composite number formulas, a procedure that is as laborious as it is the surest way to verifying a great number’s primality. (So, it is possible to substitute planned division for trial division.)

Keywords: trinary affinity, difference, similarity, realistic zero

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2951 Use of Concept Maps as a Tool for Evaluating Students' Understanding of Science

Authors: Aregamalage Sujeewa Vijayanthi Polgampala, Fang Huang

Abstract:

This study explores the genesis and development of concept mapping as a useful tool for science education and its effectiveness as technique for teaching and learning and evaluation for secondary science in schools and the role played by National College of Education science teachers. Concept maps, when carefully employed and executed serves as an integral part of teaching method and measure of effectiveness of teaching and tool for evaluation. Research has shown that science concept maps can have positive influence on student learning and motivation. The success of concept maps played in an instruction class depends on the type of theme selected, the development of learning outcomes, and the flexibility of instruction in providing library unit that is equipped with multimedia equipment where learners can interact. The study was restricted to 6 male and 9 female respondents' teachers in third-year internship pre service science teachers in Gampaha district Sri Lanka. Data were collected through 15 item questionnaire provided to learners and in depth interviews and class observations of 18 science classes. The two generated hypotheses for the study were rejected, while the results revealed that significant difference exists between factors influencing teachers' choice of concept maps, its usefulness and problems hindering the effectiveness of concept maps for teaching and learning process of secondary science in schools. It was examined that concept maps can be used as an effective measure to evaluate students understanding of concepts and misconceptions. Even the teacher trainees could not identify, key concept is on top, and subordinate concepts fall below. It is recommended that pre service science teacher trainees should be provided a thorough training using it as an evaluation instrument.

Keywords: concept maps, evaluation, learning science, misconceptions

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2950 Perceptions of Research Staff on the Implementation of Each-B Study: A Randomised Controlled Trial

Authors: Laila Khawaja

Abstract:

In recent years, an increasing emphasis has been placed on measuring program implementation, in part because of the great variability in how complex interventions are delivered in real-life settings. There is an increased awareness that while conducting process evaluations, one should aim to identify and understand the complexities of intervention if they are to be used for future intervention development or the strategies needed to implement the same intervention in a different setting. Complex interventions are public health interventions that are not drugs or surgical procedures but have many potential active aspects of intervention. In this paper, process evaluations are aligned with MRC guidelines to identify contextual factors related to outcomes to assess the quality of implementation. This paper briefly discusses the perceptions of research team on the implementation of the intervention of ‘Engaging Adolescents in Changing Behaviour’ (EACH-B), a school-based complex intervention study aiming to improve diet and physical activity among adolescents aged 12-13 years. Through qualitative interviews and focus groups with 10 staff members, we aimed to understand their experiences and reflections on implementing the EACH-B trial delivered in 49 Schools around Hampshire, England. Data were uploaded into NVivo, and analysis was conducted using thematic analysis. The investigation revealed two overarching themes: (a) how the communication patterns with teachers were impacted during the delivery of implementation and (b) what were the team’s strategies to keep logistics aligned with the research process that impacted the overall implementation of the trial. The paper informs adaptation strategies used by the research team to establish and maintain effective communication with the teachers as well as the thoughtfulness of the team’s logistic strategy for the successful delivery of the trial.

Keywords: complex interventions, process evaluation, adaptation strategies, randomised controlled trial

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2949 A Semidefinite Model to Quantify Dynamic Forces in the Powertrain of Torque Regulated Bascule Bridge Machineries

Authors: Kodo Sektani, Apostolos Tsouvalas, Andrei Metrikine

Abstract:

The reassessment of existing movable bridges in The Netherlands has created the need for acceptance/rejection criteria to assess whether the machineries are meet certain design demands. However, the existing design code defines a different limit state design, meant for new machineries which is based on a simple linear spring-mass model. Observations show that existing bridges do not confirm the model predictions. In fact, movable bridges are nonlinear systems consisting of mechanical components, such as, gears, electric motors and brakes. Next to that, each movable bridge is characterized by a unique set of parameters. However, in the existing code various variables that describe the physical characteristics of the bridge are neglected or replaced by partial factors. For instance, the damping ratio ζ, which is different for drawbridges compared to bascule bridges, is taken as a constant for all bridge types. In this paper, a model is developed that overcomes some of the limitations of existing modelling approaches to capture the dynamics of the powertrain of a class of bridge machineries First, a semidefinite dynamic model is proposed, which accounts for stiffness, damping, and some additional variables of the physical system, which are neglected by the code, such as nonlinear braking torques. The model gives an upper bound of the peak forces/torques occurring in the powertrain during emergency braking. Second, a discrete nonlinear dynamic model is discussed, with realistic motor torque characteristics during normal operation. This model succeeds to accurately predict the full time history of the occurred stress state of the opening and closing cycle for fatigue purposes.

Keywords: Dynamics of movable bridges, Bridge machinery, Powertrains, Torque measurements

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2948 Obesity and Physical Inactivity: Contributing Factors to Hypertension in Early Adults

Authors: Sadaf Ambreen, Ayesha Bibi, Sara Rafiq

Abstract:

Hypertension is a medical condition in which blood pressure in the arteries is elevated than the normal, having systolic blood pressure more than 120mmHg and diastolic blood pressure more than 80 mmHg. It leads to health complications and increase the risk of diseases such as stroke, heart failure, heart attack, and even death. The aim of the current study was to evaluate nutritional status and activity level among hypertensive early adults in District Mardan Data was collected from the subjects of Public Hospital, Mardan Medical Complex, through questionnaire. A complete information about individual sociodemographic, anthropometry and health status were collected, and physical activity was assessed by using IPAQ questionnaire. A total of 150 individuals were included in the study, in which 90% were females, and 10% were males. Data was analyzed through SPSS Version 22. Majority of the study subjects, 88%, were married, 70% having nuclear living system, 43% were having elementary education, and 43% were working as laborer. Body mass index and waist circumference in female counterpart were found to be positively associated with hypertension and was found statistically significant P=<0.01. Results showed that majority of females were fall in hypertension crisis category with mild activity, and males were having hypertension stage 1 with moderate activity. Our study concluded that non-optimal nutritional status and physical inactivity resulted in elevated blood pressure in females, therefore, lifestyle change such as optimal nutritional status and physical activity may play key role in reducing risk of hypertension.

Keywords: obesity/overwight, body mass index, waist circumference, early adulthood

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2947 Characteristics and Prevalence of Anaemia among Mothers and Young Children in Rural Uganda

Authors: Pamela E. Mukaire

Abstract:

Anemia and chronic energy deficiency are significant manifestations of poor nutritional health. Anaemia and nutritional status screening are practical ways for assessing the prevalence of iron deficiency anemia in the food insecure populations with large groups of childbearing women and children. The objective of the study was to assess anemia prevalence and other clinical manifestations of malnutrition among pairs of mothers and young children in rural Uganda. This community cross-sectional study used consecutive sampling to select 214 mothers and 214 children for the study. Data was generated using structured questionnaire, anthropometric measurements and on site analysis for anemia. Bivariable and multivariable analyses were used to assess the effect of different factors on anaemia. Of the 214 mothers, 54.2% were 25-34 years of age, 76.7% unmarried, 63% low income, and 55% had more than four children. Of the 214 children, 57% were female, 50% between 1 to 3 years of age and 35% under one year, and. Overall, 38% of the households had more 4 children under the age of 12. The prevalence of anemia was 48% for mothers and 72% for children; 20.6% of mothers had moderate to severe chronic energy deficiency, 39% had moderately-severe anaemia (10 to 7.1 g/dL). Among children, 53% had moderately-severe anaemia, and 18.2% had severe anaemia. Parity X2 =20, p < .037, number of children under 12 years living in a household X2 =10, p < .015, and child’s gender X2 =6.5, p < .038, had a significant relationship with maternal anaemia. There was a significant relationship between household income X2 =10, p < .005, marital status X2 =9, p < .011, owing a piece of land X2 =18, p < .000, owing home X2 =7, p < .036, and anaemia in children. The prevalence of anemia was high in both mothers and children. Income, marital status, owing a piece of land, owing home, number of children under age 12 in a household were associated with anaemia. Hence, efforts should be made for early diagnosis and management of anaemia deficiencies with special emphasis on those households with large number of children under age 12.

Keywords: anemia, maternal-child, nutrition, rural population

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2946 Reading High Rise Residential Development in Istanbul on the Theory of Globalization

Authors: Tuba Sari

Abstract:

One of the major transformations caused by the industrial revolution, technological developments and globalization is undoubtedly acceleration of urbanization process. Globalization, in particular, is one of the major factors that trigger this transformation. In this context, as a result of the global metropolitan city system, multifunctional rising structure forms are becoming undeniable fact of the world’s leading metropolises as the manifestation of prestige and power with different life choices, easy accessibility to services related to the era of technology. The scope of research deals with five different urban centers in İstanbul where high-rise housing is increasing dramatically after 2000’s. Therefore, the research regards multi-centered urban residential pattern being created by high-rise housing structures in the city. The methodology of the research is based on two main issue, one of them is related to sampling method of high-rise housing projects in İstanbul, while the other method of the research is based on the model of Semantics. In the framework of research hypothesis, it is aimed to prove that the character of vertical intensive structuring in Istanbul is based on seeking of different forms and images in the expressive quality, considering the production of existing high-rise buildings in residential areas in recent years. In respect to rising discourse of 'World City' in the globalizing world, it is very important to state the place of Istanbul in other developing world metropolises. In the perspective of 'World City' discourse, Istanbul has different projects concerning with globalization, international finance companies, cultural activities, mega projects, etc. In brief, the aim of this research is examining transformation forms of high-rise housing development in Istanbul within the frame of developing world cities, searching and analyzing discourse and image related to these projects.

Keywords: globalization, high-rise, housing, image

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2945 Spectrum and Prevalence of Candida Infection in Diabetic Foot Ulcers

Authors: Seyed Reza Aghili, Tahereh Shokohi, Lotfollah Davoodi, Zahra Kashi, Azam Moslemi, Mahdi Abastabar, Iman Haghani, Sabah Mayahi, Asoudeh A.

Abstract:

Introduction: In diabetic foot ulcers, if fungal agents such as Candida species penetrate into the cutaneous or depth of ulcer, can increase the degree of the wound and cause Candia infection and make it more difficult to heal. Material & Methods: A cross-sectional study was performed on 100 diabetic foot ulcer patients in 2020 in Sari, Iran. patient's data and wound grade were recorded in a questionnaire. Candida infection was diagnosed with direct microscopic examination and culture of samples. Colony-PCR molecular method was used for ITS region of DNA and then PCR-RFLP with Msp1 enzyme and using HWP1 specific gene to determine species of Candida agent. Results: Of 100 patients, the mean age 62.1 ± 10.8 years, 95% type 2 diabetes, 83%>10 years duration diabetes, 59% male, 66%> poor education level, 99% married, 52% rural, 95% neuropathic symptoms, 88% using antibiotics, 69%HbA1C >9%, and mean ulcer degree 2.6±1.05 were. Candida infection was seen in 13% of the deep tissue of the wound and 7% cutaneous around the wound. The predominant Candida isolated was C. parapsilosis (71.5%), C .albicans (14.3%). Fungal infections caused by mold fungi were not detected. There was a statistically significant relationship between yeast infection and gender, rural, HbA1C and ulcer degree. Conclusion: Mycological evaluations often are ignored. Candida parapsilosis is the most common infectious agent in these patients and may require specific treatment. Therefore, more attention of physicians to Candida infections particularly, early diagnosis and effective treatment can help faster recovery and prevent amputation.

Keywords: diabetic foot ulcer, candida infection, risk factors, c. parapsilosis

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2944 Women's Use of Maternal Health-Care Services in Hawassa Zuriya Worda: A Qualitative Study of Women's Childbearing Preference Location

Authors: Elin Mordal, Meseret Tsegaye, Hirut Gemeda, Ingeborg Ulvund

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Background: Even the rural-urban gap in the provision of skilled care during childbirth has narrowed, developing countries have the highest percentage of maternal deaths. More important than uncovering deficiencies during pregnancy, is preventing situations of risk during childbirth. The aim of this study was to identify factors women in the rural area consider before they decide where to give birth. Methods: This study utilizes a qualitative descriptive design based on individual interviews with 25 women of childbearing age who has given birth at least once, where women who delivered both at home and a health centre were included. Data collection took place in rural areas around Hawassa Zuriya Worda in Ethiopia February 2015. To identify conditions associated to where women prefer to give birth a thematic analysis was carried out. Result: Experienced risks regarding child birth were the most common reason for women and their families to seek help from skilled birth attendants. Decision-making and planning were identified as a major factor contributing to where women give birth. The women’s position and responsibilities pointed to the fact that women's role is mainly to take care of children and manage the household, while husbands, mother in laws and the elderly are the family members who take most of the decisions. This includes decision about where women give birth. The infrastructure also influences where women choose to give birth. Conclusion: To further improve childbirth care in Hawassa Zuriya Worda it’s important that women get positive experiences, and are met in a safe and supportive way at Health Centers. Challenges appear to women’s autonomy, quality aspects, and infrastructure.

Keywords: childbirth, women, health care utilization, Hawassa Zuriya Worda, Ethiopia, rural area

Procedia PDF Downloads 200