Search results for: practices and cases in e-education
Commenced in January 2007
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Edition: International
Paper Count: 8499

Search results for: practices and cases in e-education

459 Examining Child Rape Provisions of Bangladesh in Comparison with Other South Asian Countries

Authors: Monira Nazmi Jahan

Abstract:

Child rape or child abuse is a serious and fearsome crime against children, which is an epidemic almost in every state of today’s world. However, in the case of Bangladesh, the scenario is terrifying. The objective of this paper is to examine the laws relating to child rape in Bangladesh as according to a renowned Daily Newspaper 'Prothom Alo', nearly 346 children are being raped since January 2019. This paper discusses and draws the difference of child rape provisions of Bangladesh with other South-Asian countries, comprises of India, Maldives, Pakistan, Sri Lanka, Nepal, Bhutan, and Afghanistan. In Bangladesh, girls below 18 years are considered to be a child. ‘The Penal Code, 1860’ and a special law ‘Nari O Shishu Nirjatan Daman Ain, 2012’ provides that any person committing child rape will be punished with rigorous life imprisonment and fine. This piece of law also gives provisions for punishment in case of child’s death after the commission of rape and gang rape, and the punishment is the death penalty. In India there is ‘The Protection of Children from Sexual Offences Act, 2012’ (POSCO) which has separate provisions for sexual assault, penetrative sexual assault and aggravated penetrative sexual assault by different categories of person such as relatives, institutional officers and trustees and also for mentally and physically challenged child victims and provides punishment up to death penalty. In Pakistan, there is ‘Pakistan Penal Code Amended Act, 2016’ which has only two provisions for child rape. In case offence committed by one person, the punishment is 10 to 25 years of imprisonment and fine. In case of offence committed by two or more persons, each shall be liable to death or imprisonment for life. Unfortunately, Afghanistan has no laws for the protection of rape victims of women let alone children, whereas there are a lot of child rape cases, including both girls and boys who are used for sexual slavery. The Maldives has a special law named ‘Special Provisions Act to Deal with Child Sex Abuse Offenders.’ This has categorized the offenders like POSCO and has provided punishments accordingly. The punishments are: punishments range from 1 to 25 years accordingly, whereas Bangladesh has lesser provisions, but the gravity and duration of punishments are much higher. The Penal Code of Sri Lanka imposes a minimum sentence of 10 years for those convicted of raping a child under 18 years. In Bhutan, child rape provision is made according to the age of a child. ‘The Penal Code of Bhutan, 2004’, mentions provisions for the rape of a child in case of child rape below and above 12 years, gang rape of a child below and above 12 years and has graded the punishments as first, second and third degree. Though Bangladesh has better provisions for punishments, the ages are not categorized in the laws. In Nepal there is ‘Act relating to Children, 2018’ provisions are made for offenders who use or cause or engage child sexual exploitation, and the punishment is same for rape offenders according to prevailing laws in Nepal. No separate punishments for child offenders are made. The ultimate conclusion that can be drawn is Bangladesh has better punishments than all other South-Asian countries and same punishment as India however, Bangladesh can make or amend the laws and categorize offenders as like POSCO of India, Special provisions of Maldives and Bhutan.

Keywords: child rape, death penalty, sexual slavery, South Asia

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458 Legal Pluralism and Ideology: The Recognition of the Indigenous Justice Administration in Bolivia through the "Indigenismo" and "Decolonisation" Discourses

Authors: Adriana Pereira Arteaga

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In many Latin American countries the transition towards legal pluralism - has developed as part of what is called Latin-American-Constitutionalism over the last thirty years. The aim of this paper is to discuss how legal pluralism in its current form in Bolivia may produce exclusion and violence. Legal sources and discourse analysis - as an approach to examine written language on discourse documentation- will be used to develop this paper. With the constitution of 2009, Bolivia was symbolically "re-founded" into a multi-nation state. This shift goes hand in hand with the "indigenista" and "decolonisation" ideologies developing since the early 20th century. Discourses based on these ideologies reflect the rejection of liberal and western premises on which the Bolivian republic was originally built after independence. According to the "indigenista" movements, the liberal nation-state generates institutions corresponding to a homogenous society. These liberal institutions not only ignore the Bolivian multi-nation reality, but also maintain the social structures originating form the colony times, based on prejudices against the indigenous. The described statements were elaborated through the image: the indigenous people humiliated by a cruel western system as highlighted by the constitution's preamble. This narrative had a considerable impact on the sensitivity of people and received great social support. Therefore the proposal for changing structures of the nation-state, is charged with an emancipatory message of restoring even the pre-Columbian order. An order at times romantically described as the perfect order. Legally this connotes a rejection of the positivistic national legal system based on individual rights and the promotion of constitutional recognition of indigenous justice administration. The pluralistic Constitution is supposed to promote tolerance and a peaceful coexistence among nations, so that the unity and integrity of the country could be maintained. In its current form, legal pluralism in Bolivia is justified on pre-existing rights contained for example in the International - Labour - Organization - Convention 169, but it is more developed on the described discursive constructions. Over time these discursive constructions created inconsistencies in terms of putting indigenous justice administration into practice: First, because legal pluralism has been more developed on level of political discourse, so a real interaction between the national and the indigenous jurisdiction cannot be observed. There are no clear coordination and cooperation mechanisms. Second, since the recently reformed constitution is based on deep sensitive experiences, little is said about the general legal principles on which a pluralistic administration of justice in Bolivia should be based. Third, basic rights, liberties, and constitutional guarantees are also affected by the antagonized image of the national justice administration. As a result, fundamental rights could be violated on a large scale because many indigenous justice administration practices run counter to these constitutional rules. These problems are not merely Bolivian but may also be encountered in other regional countries with similar backgrounds, like Ecuador.

Keywords: discourse, indigenous justice, legal pluralism, multi-nation

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457 A Functional Analysis of a Political Leader in Terms of Marketing

Authors: Aşina Gülerarslan, M. Faik Özdengül

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The new economic, social and political world order has led to the emergence of a wide range of persuasion strategies and practices based on an ever expanding marketing axis that involves organizations, ideas and persons as well as products and services. It is seen that since the 1990's, a wide variety of competitive marketing ideas have been offered systematically to target audiences in the field of politics as in other fields. When the components of marketing are taken into consideration, all kinds of communication efforts involving “political leaders”, who are conceptualized as products in terms of political marketing, serve a process of social persuasion, which cannot be restricted to election periods only, and a manageable “image”. In this context, image, which is concerned with how the political product is perceived, involves not only the political discourses shared with the public but also all kinds of biographical information about the leader, the leader’s specific way of living and routines and his/her attitudes and behaviors in their private lives, and all these are regarded as components of the “product image”. While on the one hand the leader’s verbal or supra-verbal references serve the way the “spirit of the product” is perceived –just as in brand positioning- they also show their self-esteem levels, in other words how they perceive themselves on the other hand. Indeed, their self-esteem levels are evaluated in three fundamental categories in the “Functional Analysis”, namely parent, child and adult, and it is revealed that the words, tone of voice and body language a person uses makes it easy to understand at what self-esteem level that person is. In this context, words, tone of voice and body language, which provide important clues as to the “self” of the person, are also an indication of how political leaders evaluate both “themselves” and “the mass/audience” in the communication they establish with their audiences. When the matter is taken from the perspective of Turkey, the levels of self-esteem in the relationships that the political leaders establish with the masses are also important in revealing how our society is seen from the perspective of a specific leader. Since the leader is a part of the marketing strategy of a political party as a product, this evaluation is significant in terms of the forms of relationships between political institutions in our country with the society. In this study, the self-esteem level in the documentary entitled “Master’s Story”, where Recep Tayyip Erdoğan’s life history is told, is analyzed in the context of words, tone of voice and body language. Within the scope of the study, at what level of self-esteem Recep Tayyip Erdoğan was in the “Master’s Story”, a documentary broadcast on Beyaz TV, was investigated using the content analysis method. First, based on the Functional Analysis Literature, a transactional approach scale was created regarding parent, adult and child self-esteem levels. On the basis of this scale, the prime minister’s self-esteem level was determined in three basic groups, namely “tone of voice”, “the words he used” and “body language”. Descriptive analyses were made to the data within the framework of these criteria and at what self-esteem level the prime minister spoke throughout the documentary was revealed.

Keywords: political marketing, leader image, level of self-esteem, transactional approach

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456 The Duty of Sea Carrier to Transship the Cargo in Case of Vessel Breakdown

Authors: Mojtaba Eshraghi Arani

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Concluding the contract for carriage of cargo with the shipper (through bill of lading or charterparty), the carrier must transport the cargo from loading port to the port of discharge and deliver it to the consignee. Unless otherwise agreed in the contract, the carrier must avoid from any deviation, transfer of cargo to another vessel or unreasonable stoppage of carriage in-transit. However, the vessel might break down in-transit for any reason and becomes unable to continue its voyage to the port of discharge. This is a frequent incident in the carriage of goods by sea which leads to important dispute between the carrier/owner and the shipper/charterer (hereinafter called “cargo interests”). It is a generally accepted rule that in such event, the carrier/owner must repair the vessel after which it will continue its voyage to the destination port. The dispute will arise in the case that temporary repair of the vessel cannot be done in the short or reasonable term. There are two options for the contract parties in such a case: First, the carrier/owner is entitled to repair the vessel while having the cargo onboard or discharged in the port of refugee, and the cargo interests must wait till the breakdown is rectified at any time, whenever. Second, the carrier/owner will be responsible to charter another vessel and transfer the entirety of cargo to the substitute vessel. In fact, the main question revolves around the duty of carrier/owner to perform transfer of cargo to another vessel. Such operation which is called “trans-shipment” or “transhipment” (in terms of the oil industry it is usually called “ship-to-ship” or “STS”) needs to be done carefully and with due diligence. In fact, the transshipment operation for various cargoes might be different as each cargo requires its own suitable equipment for transfer to another vessel, so this operation is often costly. Moreover, there is a considerable risk of collision between two vessels in particular in bulk carriers. Bulk cargo is also exposed to the shortage and partial loss in the process of transshipment especially during bad weather. Concerning tankers which carry oil and petrochemical products, transshipment, is most probably followed by sea pollution. On the grounds of the above consequences, the owners are afraid of being held responsible for such operation and are reluctant to perform in the relevant disputes. The main argument raised by them is that no regulation has recognized such duty upon their shoulders so any such operation must be done under the auspices of the cargo interests and all costs must be reimbursed by themselves. Unfortunately, not only the international conventions including Hague rules, Hague-Visby Rules, Hamburg rules and Rotterdam rules but also most domestic laws are silent in this regard. The doctrine has yet to analyse the issue and no legal researches was found out in this regard. A qualitative method with the concept of interpretation of data collection has been used in this paper. The source of the data is the analysis of regulations and cases. It is argued in this article that the paramount rule in the maritime law is “the accomplishment of the voyage” by the carrier/owner in view of which, if the voyage can only be finished by transshipment, then the carrier/owner will be responsible to carry out this operation. The duty of carrier/owner to apply “due diligence” will strengthen this reasoning. Any and all costs and expenses will also be on the account pf the owner/carrier, unless the incident is attributable to any cause arising from the cargo interests’ negligence.

Keywords: cargo, STS, transshipment, vessel, voyage

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455 Analysis of the Effects of Institutions on the Sub-National Distribution of Aid Using Geo-Referenced AidData

Authors: Savas Yildiz

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The article assesses the performance of international aid donors to determine the sub-national distribution of their aid projects dependent on recipient countries’ governance. The present paper extends the scope from a cross-country perspective to a more detailed analysis by looking at the effects of institutional qualities on the sub-national distribution of foreign aid. The analysis examines geo-referenced aid project in 37 countries and 404 regions at the first administrative division level in Sub-Saharan Africa from the World Bank (WB) and the African Development Bank (ADB) that were approved between the years 2000 and 2011. To measure the influence of institutional qualities on the distribution of aid the following measures are used: control of corruption, government effectiveness, regulatory quality and rule of law from the World Governance Indicators (WGI) and the corruption perception index from Transparency International. Furthermore, to assess the importance of ethnic heterogeneity on the sub-national distribution of aid projects, the study also includes interaction terms measuring ethnic fragmentation. The regression results indicate a general skew of aid projects towards regions which hold capital cities, however, being incumbent presidents’ birth region does not increase the allocation of aid projects significantly. Nevertheless, with increasing quality of institutions aid projects are less skewed towards capital regions and the previously estimated coefficients loose significance in most cases. Higher ethnic fragmentation also seems to impede the possibility to allocate aid projects mainly in capital city regions and presidents’ birth places. Additionally, to assess the performance of the WB based on its own proclaimed goal to aim the poor in a country, the study also includes sub-national wealth data from the Demographic and Health Surveys (DSH), and finds that, even with better institutional qualities, regions with a larger share from the richest quintile receive significantly more aid than regions with a larger share of poor people. With increasing ethnic diversity, the allocation of aid projects towards regions where the richest citizens reside diminishes, but still remains high and significant. However, regions with a larger share of poor people still do not receive significantly more aid. This might imply that the sub-national distribution of aid projects increases in general with higher ethnic fragmentation, independent of the diverse regional needs. The results provide evidence that institutional qualities matter to undermine the influence of incumbent presidents on the allocation of aid projects towards their birth regions and capital regions. Moreover, even for countries with better institutional qualities the WB and the ADB do not seem to be able to aim the poor in a country with their aid projects. Even, if one considers need-based variables, such as infant mortality and child mortality rates, aid projects do not seem to be allocated in districts with a larger share of people in need. Therefore, the study provides further evidence using more detailed information on the sub-national distribution of aid projects that aid is not being allocated effectively towards regions with a larger share of poor people to alleviate poverty in recipient countries directly. Institutions do not have any significant influence on the sub-national distribution of aid towards the poor.

Keywords: aid allocation, georeferenced data, institutions, spatial analysis

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454 Ground Motion Modeling Using the Least Absolute Shrinkage and Selection Operator

Authors: Yildiz Stella Dak, Jale Tezcan

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Ground motion models that relate a strong motion parameter of interest to a set of predictive seismological variables describing the earthquake source, the propagation path of the seismic wave, and the local site conditions constitute a critical component of seismic hazard analyses. When a sufficient number of strong motion records are available, ground motion relations are developed using statistical analysis of the recorded ground motion data. In regions lacking a sufficient number of recordings, a synthetic database is developed using stochastic, theoretical or hybrid approaches. Regardless of the manner the database was developed, ground motion relations are developed using regression analysis. Development of a ground motion relation is a challenging process which inevitably requires the modeler to make subjective decisions regarding the inclusion criteria of the recordings, the functional form of the model and the set of seismological variables to be included in the model. Because these decisions are critically important to the validity and the applicability of the model, there is a continuous interest on procedures that will facilitate the development of ground motion models. This paper proposes the use of the Least Absolute Shrinkage and Selection Operator (LASSO) in selecting the set predictive seismological variables to be used in developing a ground motion relation. The LASSO can be described as a penalized regression technique with a built-in capability of variable selection. Similar to the ridge regression, the LASSO is based on the idea of shrinking the regression coefficients to reduce the variance of the model. Unlike ridge regression, where the coefficients are shrunk but never set equal to zero, the LASSO sets some of the coefficients exactly to zero, effectively performing variable selection. Given a set of candidate input variables and the output variable of interest, LASSO allows ranking the input variables in terms of their relative importance, thereby facilitating the selection of the set of variables to be included in the model. Because the risk of overfitting increases as the ratio of the number of predictors to the number of recordings increases, selection of a compact set of variables is important in cases where a small number of recordings are available. In addition, identification of a small set of variables can improve the interpretability of the resulting model, especially when there is a large number of candidate predictors. A practical application of the proposed approach is presented, using more than 600 recordings from the National Geospatial-Intelligence Agency (NGA) database, where the effect of a set of seismological predictors on the 5% damped maximum direction spectral acceleration is investigated. The set of candidate predictors considered are Magnitude, Rrup, Vs30. Using LASSO, the relative importance of the candidate predictors has been ranked. Regression models with increasing levels of complexity were constructed using one, two, three, and four best predictors, and the models’ ability to explain the observed variance in the target variable have been compared. The bias-variance trade-off in the context of model selection is discussed.

Keywords: ground motion modeling, least absolute shrinkage and selection operator, penalized regression, variable selection

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453 Keeping under the Hat or Taking off the Lid: Determinants of Social Enterprise Transparency

Authors: Echo Wang, Andrew Li

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Transparency could be defined as the voluntary release of information by institutions that is relevant to their own evaluation. Transparency based on information disclosure is recognised to be vital for the Third Sector, as civil society organisations are under pressure to become more transparent to answer the call for accountability. The growing importance of social enterprises as hybrid organisations emerging from the nexus of the public, the private and the Third Sector makes their transparency a topic worth exploring. However, transparency for social enterprises has not yet been studied: as a new form of organisation that combines non-profit missions with commercial means, it is unclear to both the practical and the academic world if the shift in operational logics from non-profit motives to for-profit pursuits has significantly altered their transparency. This is especially so in China, where informational governance and practices of information disclosure by local governments, industries and civil society are notably different from other countries. This study investigates the transparency-seeking behaviour of social enterprises in Greater China to understand what factors at the organisational level may affect their transparency, measured by their willingness to disclose financial information. We make use of the Survey on the Models and Development Status of Social Enterprises in the Greater China Region (MDSSGCR) conducted in 2015-2016. The sample consists of more than 300 social enterprises from the Mainland, Hong Kong and Taiwan. While most respondents have provided complete answers to most of the questions, there is tremendous variation in the respondents’ demonstrated level of transparency in answering those questions related to the financial aspects of their organisations, such as total revenue, net profit, source of revenue and expense. This has led to a lot of missing data on such variables. In this study, we take missing data as data. Specifically, we use missing values as a proxy for an organisation’s level of transparency. Our dependent variables are constructed from missing data on total revenue, net profit, source of revenue and cost breakdown. In addition, we also take into consideration the quality of answers in coding the dependent variables. For example, to be coded as being transparent, an organization must report the sources of at least 50% of its revenue. We have four groups of predictors of transparency, namely nature of organization, decision making body, funding channel and field of concentration. Furthermore, we control for an organisation’s stage of development, self-identity and region. The results show that social enterprises that are at their later stages of organisational development and are funded by financial means are significantly more transparent than others. There is also some evidence that social enterprises located in the Northeast region in China are less transparent than those located in other regions probably because of local political economy features. On the other hand, the nature of the organisation, the decision-making body and field of concentration do not systematically affect the level of transparency. This study provides in-depth empirical insights into the information disclosure behaviour of social enterprises under specific social context. It does not only reveal important characteristics of Third Sector development in China, but also contributes to the general understanding of hybrid institutions.

Keywords: China, information transparency, organisational behaviour, social enterprise

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452 Nurse Participation for the Economical Effectiveness in Medical Organizations

Authors: Alua Masalimova, Dameli Sulubecova, Talgat Isaev, Raushan Magzumova

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The usual relation to nurses of heads of medical organizations in Kazakhstan is to use them only for per performing medical manipulations, but new economic conditions require the introduction of nursing innovations. There is an increasing need for managers of hospital departments and regions of ambulatory clinics to ensure comfortable conditions for doctors, nurses, aides, as well as monitoring marketing technology (the needs and satisfaction of staff work, the patient satisfaction of the department). It is going to the past the nursing activities as physician assistant performing his prescriptions passively. We are suggesting a model for the developing the head nurse as the manager on the example of Blood Service. We have studied in the scientific-production center of blood transfusion head nurses by the standard method of interviewing for involvement in coordinating the flow of information, promoting the competitiveness of the department. Results: the average age of the respondents 43,1 ± 9,8, female - 100%; manager in the Organization – 9,3 ± 10,3 years. Received positive responses to the knowledge of the nearest offices in providing similar medical service - 14,2%. The cost of similar medical services in other competitive organizations did not know 100%, did a study of employee satisfaction Division labour-85,7% answered negatively, the satisfaction donors work staff studied in 50.0% of cases involved in attracting paid Services Division showed a 28.5% of the respondent. Participation in management decisions medical organization: strategic planning - 14,2%, forming analysis report for the year – 14,2%, recruitment-30.0%, equipment-14.2%. Participation in the social and technical designing workplaces Division staff showed 85,0% of senior nurses. Participate in the cohesion of the staff of the Division method of the team used the 10.0% of respondents. Further, we have studied the behavioral competencies for senior sisters: customer focus – 20,0% of respondents have attended, the ability to work in a team – 40,0%. Personal qualities senior nurses were apparent: sociability – 80,0%, the ability to manage information – 40,0%, to make their own decisions - 14,2%, 28,5% creativity, the desire to improve their professionalism – 50,0%. Thus, the modern market conditions dictate this organization, which works for the rights of economic management; include the competence of the post of the senior nurse knowledge and skills of Marketing Management Department. Skills to analyses the information collected and use of management offers superior medical leadership organization. The medical organization in the recruitment of the senior nurse offices take into account personal qualities: flexibility, fluency of thinking, communication skills and ability to work in a team. As well as leadership qualities, ambition, high emotional and social intelligence, that will bring out the medical unit on competitiveness within the country and abroad.

Keywords: blood service, head nurse, manager, skills

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451 Differentiating Third Instar Larvae of Three Species of Flies (Family: Sarcophagidae) of Potential Forensic Importance in Jamaica, Using Morphological Characteristics

Authors: Rochelle Daley, Eric Garraway, Catherine Murphy

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

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

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450 Crisis Management and Corporate Political Activism: A Qualitative Analysis of Online Reactions toward Tesla

Authors: Roxana D. Maiorescu-Murphy

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In the US, corporations have recently embraced political stances in an attempt to respond to the external pressure exerted by activist groups. To date, research in this area remains in its infancy, and few studies have been conducted on the way stakeholder groups respond to corporate political advocacy in general and in the immediacy of such a corporate announcement in particular. The current study aims to fill in this research void. In addition, the study contributes to an emerging trajectory in the field of crisis management by focusing on the delineation between crises (unexpected events related to products and services) and scandals (crises that spur moral outrage). The present study looked at online reactions in the aftermath of Elon Musk’s endorsement of the Republican party on Twitter. Two data sets were collected from Twitter following two political endorsements made by Elon Musk on May 18, 2022, and June 15, 2022, respectively. The total sample of analysis stemming from the data two sets consisted of N=1,374 user comments written as a response to Musk’s initial tweets. Given the paucity of studies in the preceding research areas, the analysis employed a case study methodology, used in circumstances in which the phenomena to be studied had not been researched before. According to the case study methodology, which answers the questions of how and why a phenomenon occurs, this study responded to the research questions of how online users perceived Tesla and why they did so. The data were analyzed in NVivo by the use of the grounded theory methodology, which implied multiple exposures to the text and the undertaking of an inductive-deductive approach. Through multiple exposures to the data, the researcher ascertained the common themes and subthemes in the online discussion. Each theme and subtheme were later defined and labeled. Additional exposures to the text ensured that these were exhaustive. The results revealed that the CEO’s political endorsements triggered moral outrage, leading to Tesla’s facing a scandal as opposed to a crisis. The moral outrage revolved around the stakeholders’ predominant rejection of a perceived intrusion of an influential figure on a domain reserved for voters. As expected, Musk’s political endorsements led to polarizing opinions, and those who opposed his views engaged in online activism aimed to boycott the Tesla brand. These findings reveal that the moral outrage that characterizes a scandal requires communication practices that differ from those that practitioners currently borrow from the field of crisis management. Specifically, because scandals flourish in online settings, practitioners should regularly monitor stakeholder perceptions and address them in real-time. While promptness is essential when managing crises, it becomes crucial to respond immediately as a scandal is flourishing online. Finally, attempts should be made to distance a brand, its products, and its CEO from the latter’s political views.

Keywords: crisis management, communication management, Tesla, corporate political activism, Elon Musk

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449 Sustainability in Space: Implementation of Circular Economy and Material Efficiency Strategies in Space Missions

Authors: Hamda M. Al-Ali

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The ultimate aim of space exploration has been centralized around the possibility of life on other planets in the solar system. This aim is driven by the detrimental effects that climate change could potentially have on human survival on Earth in the future. This drives humans to search for feasible solutions to increase environmental and economical sustainability on Earth and to evaluate and explore the ability of human survival on other planets such as Mars. To do that, frequent space missions are required to meet the ambitious human goals. This means that reliable and affordable access to space is required, which could be largely achieved through the use of reusable spacecrafts. Therefore, materials and resources must be used wisely to meet the increasing demand. Space missions are currently extremely expensive to operate. However, reusing materials hence spacecrafts, can potentially reduce overall mission costs as well as the negative impact on both space and Earth environments. This is because reusing materials leads to less waste generated per mission, and therefore fewer landfill sites are required. Reusing materials reduces resource consumption, material production, and the need for processing new and replacement spacecraft and launch vehicle parts. Consequently, this will ease and facilitate human access to outer space as it will reduce the demand for scarce resources, which will boost material efficiency in the space industry. Material efficiency expresses the extent to which resources are consumed in the production cycle and how the waste produced by the industrial process is minimized. The strategies proposed in this paper to boost material efficiency in the space sector are the introduction of key performance indicators that are able to measure material efficiency as well as the introduction of clearly defined policies and legislation that can be easily implemented within the general practices in the space industry. Another strategy to improve material efficiency is by amplifying energy and resource efficiency through reusing materials. The circularity of various spacecraft materials such as Kevlar, steel, and aluminum alloys could be maximized through reusing them directly or after galvanizing them with another layer of material to act as a protective coat. This research paper has an aim to investigate and discuss how to improve material efficiency in space missions considering circular economy concepts so that space and Earth become more economically and environmentally sustainable. The circular economy is a transition from a make-use-waste linear model to a closed-loop socio-economic model, which is regenerative and restorative in nature. The implementation of a circular economy will reduce waste and pollution through maximizing material efficiency, ensuring that businesses can thrive and sustain. Further research into the extent to which reusable launch vehicles reduce space mission costs have been discussed, along with the environmental and economic implications it could have on the space sector and the environment. This has been examined through research and in-depth literature review of published reports, books, scientific articles, and journals. Keywords such as material efficiency, circular economy, reusable launch vehicles and spacecraft materials were used to search for relevant literature.

Keywords: circular economy, key performance indicator, material efficiency, reusable launch vehicles, spacecraft materials

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448 Statistical Models and Time Series Forecasting on Crime Data in Nepal

Authors: Dila Ram Bhandari

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Throughout the 20th century, new governments were created where identities such as ethnic, religious, linguistic, caste, communal, tribal, and others played a part in the development of constitutions and the legal system of victim and criminal justice. Acute issues with extremism, poverty, environmental degradation, cybercrimes, human rights violations, crime against, and victimization of both individuals and groups have recently plagued South Asian nations. Everyday massive number of crimes are steadfast, these frequent crimes have made the lives of common citizens restless. Crimes are one of the major threats to society and also for civilization. Crime is a bone of contention that can create a societal disturbance. The old-style crime solving practices are unable to live up to the requirement of existing crime situations. Crime analysis is one of the most important activities of the majority of intelligent and law enforcement organizations all over the world. The South Asia region lacks such a regional coordination mechanism, unlike central Asia of Asia Pacific regions, to facilitate criminal intelligence sharing and operational coordination related to organized crime, including illicit drug trafficking and money laundering. There have been numerous conversations in recent years about using data mining technology to combat crime and terrorism. The Data Detective program from Sentient as a software company, uses data mining techniques to support the police (Sentient, 2017). The goals of this internship are to test out several predictive model solutions and choose the most effective and promising one. First, extensive literature reviews on data mining, crime analysis, and crime data mining were conducted. Sentient offered a 7-year archive of crime statistics that were daily aggregated to produce a univariate dataset. Moreover, a daily incidence type aggregation was performed to produce a multivariate dataset. Each solution's forecast period lasted seven days. Statistical models and neural network models were the two main groups into which the experiments were split. For the crime data, neural networks fared better than statistical models. This study gives a general review of the applied statistics and neural network models. A detailed image of each model's performance on the available data and generalizability is provided by a comparative analysis of all the models on a comparable dataset. Obviously, the studies demonstrated that, in comparison to other models, Gated Recurrent Units (GRU) produced greater prediction. The crime records of 2005-2019 which was collected from Nepal Police headquarter and analysed by R programming. In conclusion, gated recurrent unit implementation could give benefit to police in predicting crime. Hence, time series analysis using GRU could be a prospective additional feature in Data Detective.

Keywords: time series analysis, forecasting, ARIMA, machine learning

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447 The Social Construction of Diagnosis: An Exploratory Study on Gender Dysphoria and Its Implications on Personal Narratives

Authors: Jessica Neri, Elena Faccio

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In Europe, except for Denmark and Malta, the legal gender change and the stages of the possible process of gender transition are bound to the diagnosis of a gender identity disorder. The requirement of the evaluation of a mental disorder might have many implications on trans people’s self-representations, interpersonal relations in different social contexts and the therapeutic relations with clinicians during the transition. Psychopathological language may contribute to define the individual’s reality from normative presuppositions with value implications related to the dominant cultural principles. In an effort to mark the boundaries between sanity and pathology, it concurs to the definition of the management procedures of the constructed diversities and deviances, legitimizing the operational practices of particular professional figures. The aim of this research concerns the analysis of the diagnostic category of gender dysphoria contained in the last edition of the Diagnostic and Statistical Manual of Mental Disorders. In particular, this study focuses on the relationship between the implicit and explicit assumptions related to the expressions of gender non-conformity, that sustain the language and the criteria characterizing the Manual, and the possible implications on people’s narratives of transition. In order to achieve this objective two main research methods were used: historical reconstruction of the diagnostic category in the different versions of the Manual and content analysis of that category in the present version. From the historical analysis, in the medical and psychiatric field gender non-conformity has been predominantly explicated by naturalistic perspectives, naming it ‘transsexualism’ and collocating it in the category of gender identity disorder. Currently, pathological judged experiences are represented by gender dysphoria, described in the DSM-5 as the distress that may accompany the incongruence between one's experienced or expressed gender and one's assigned gender, specifying that there must be ‘evidence’ of this. Implicit theories about gender binary, parallelism between gender identity, sex and sexuality and the understanding of the mental health and the subject’s agency as subordinated to the expert knowledge, can be found in the process of designation of the category. A lack of awareness of the historical, social and political aspects connected to the cultural and normative dimensions at the basis of these implicit theories, can be noticed and data given by culture and data given by supposed -biological or psychological- nature, are often confused. This reductionist interpretation of gender and its presumed diversities legitimize the clinician to assume the role of searching and orienting, in a correctional perspective, the biographical elements that correspond to him specific expectations, with no space for other possibilities and identity configurations for people in transition. This research may contribute to the current critical debate about the epistemological foundation of the psychodiagnosis, emphasizing the pragmatic effects on the individuals and on the psychological practice in its wider social context. This work also permits to underline the risks due to the lack of awareness of the processes of social construction of the diagnostic system and its essential role of defence of the values that hold up the symbolic universe of reference.

Keywords: diagnosis, gender dysphoria, narratives, social constructionism

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446 A Mother’s Silent Adversary: A Case of Pregnant Woman with Cervical Cancer

Authors: Paola Millare, Nelinda Catherine Pangilinan

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Background and Aim: Cervical cancer is the most commonly diagnosed gynecological malignancy during pregnancy. Owing to the rarity of the disease, and the complexity of all factors that have to be taken into consideration, standardization of treatment is very difficult. Cervical cancer is the second most common malignancy among women. The treatment of cancer during pregnancy is most challenging in the case of cervical cancer, since the pregnant uterus itself is affected. This report aims to present a case of cervical cancer in a pregnant woman and how to manage this case and several issues accompanied with it. Methods: This is a case of a 28 year-old, Gravida 4 Para 2 (1111), who presented with watery to mucoid, whitish, non-foul smelling and increasing in amount. Internal examination revealed normal external genitalia, parous outlet, cervix was transformed into a fungating mass measuring 5x4 cm, with left parametrial involvement, body of uterus was enlarged to 24 weeks size, no adnexal mass or tenderness. She had cervical punch biopsy, which revealed, adenocarcinoma, well-differentiated cervical tissue. Standard management for cases with stage 2B cervical carcinoma was to start radiation or radical hysterectomy. In the case of patients diagnosed with cervical cancer and currently pregnant, these kind of management will result to fetal loss. The patient still declined the said management and opted to delay the treatment and wait for her baby to reach at least term and proceed to cesarean section as route of delivery. Results: The patient underwent an elective cesarean section at 37th weeks age of gestation, with an outcome of a term, live baby boy APGAR score 7,9 birthweight 2600 grams. One month postpartum, the patient followed up and completed radiotherapy, chemotherapy and brachytherapy. She was advised to go back after 6 months for monitoring. On her last check up, an internal examination was done which revealed normal external genitalia, vagina admits 2 fingers with ease, there is a palpable fungating mass at the cervix measuring 2x2 cm. A repeat gynecologic oncologic ultrasound was done revealing cervical mass, endophytic, grade 1 color score with stromal invasion 35% post radiation reactive lymph nodes with intact paracolpium, pericervical, and parametrial involvement. The patient was then advised to undergo pelvic boost and for close monitoring of the cervical mass. Conclusion: Cervical cancer in pregnancy is rare but is a dilemma for women and their physicians. Treatment should be multidisciplinary and individualized following careful counseling. In this case, the treatment was clearly on the side of preventing the progression of cervical cancer while she is pregnant, however due to ethical reasons, the management deviates on the right of the patient to decide for her own health and her unborn child. The collaborative collection of data relating to treatment and outcome is strongly encouraged.

Keywords: cancer, cervical, ethical, pregnancy

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445 Various Shaped ZnO and ZnO/Graphene Oxide Nanocomposites and Their Use in Water Splitting Reaction

Authors: Sundaram Chandrasekaran, Seung Hyun Hur

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Exploring strategies for oxygen vacancy engineering under mild conditions and understanding the relationship between dislocations and photoelectrochemical (PEC) cell performance are challenging issues for designing high performance PEC devices. Therefore, it is very important to understand that how the oxygen vacancies (VO) or other defect states affect the performance of the photocatalyst in photoelectric transfer. So far, it has been found that defects in nano or micro crystals can have two possible significances on the PEC performance. Firstly, an electron-hole pair produced at the interface of photoelectrode and electrolyte can recombine at the defect centers under illumination of light, thereby reducing the PEC performances. On the other hand, the defects could lead to a higher light absorption in the longer wavelength region and may act as energy centers for the water splitting reaction that can improve the PEC performances. Even if the dislocation growth of ZnO has been verified by the full density functional theory (DFT) calculations and local density approximation calculations (LDA), it requires further studies to correlate the structures of ZnO and PEC performances. Exploring the hybrid structures composed of graphene oxide (GO) and ZnO nanostructures offer not only the vision of how the complex structure form from a simple starting materials but also the tools to improve PEC performances by understanding the underlying mechanisms of mutual interactions. As there are few studies for the ZnO growth with other materials and the growth mechanism in those cases has not been clearly explored yet, it is very important to understand the fundamental growth process of nanomaterials with the specific materials, so that rational and controllable syntheses of efficient ZnO-based hybrid materials can be designed to prepare nanostructures that can exhibit significant PEC performances. Herein, we fabricated various ZnO nanostructures such as hollow sphere, bucky bowl, nanorod and triangle, investigated their pH dependent growth mechanism, and correlated the PEC performances with them. Especially, the origin of well-controlled dislocation-driven growth and its transformation mechanism of ZnO nanorods to triangles on the GO surface were discussed in detail. Surprisingly, the addition of GO during the synthesis process not only tunes the morphology of ZnO nanocrystals and also creates more oxygen vacancies (oxygen defects) in the lattice of ZnO, which obviously suggest that the oxygen vacancies be created by the redox reaction between GO and ZnO in which the surface oxygen is extracted from the surface of ZnO by the functional groups of GO. On the basis of our experimental and theoretical analysis, the detailed mechanism for the formation of specific structural shapes and oxygen vacancies via dislocation, and its impact in PEC performances are explored. In water splitting performance, the maximum photocurrent density of GO-ZnO triangles was 1.517mA/cm-2 (under UV light ~ 360 nm) vs. RHE with high incident photon to current conversion Efficiency (IPCE) of 10.41%, which is the highest among all samples fabricated in this study and also one of the highest IPCE reported so far obtained from GO-ZnO triangular shaped photocatalyst.

Keywords: dislocation driven growth, zinc oxide, graphene oxide, water splitting

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444 The Significance of Cultural Risks for Western Consultants Executing Gulf Cooperation Council Megaprojects

Authors: Alan Walsh, Peter Walker

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Differences in commercial, professional and personal cultural traditions between western consultants and project sponsors in the Gulf Cooperation Council (GCC) region are potentially significant in the workplace, and this can impact on project outcomes. These cultural differences can, for example, result in conflict amongst senior managers, which can negatively impact the megaproject. New entrants to the GCC often experience ‘culture shock’ as they attempt to integrate into their unfamiliar environments. Megaprojects are unique ventures with individual project characteristics, which need to be considered when managing their associated risks. Megaproject research to date has mostly ignored the significance of the absence of cultural congruence in the GCC, which is surprising considering that there are large volumes of megaprojects in various stages of construction in the GCC. An initial step to dealing with cultural issues is to acknowledge culture as a significant risk factor (SRF). This paper seeks to understand the criticality for western consultants to address these risks. It considers the cultural barriers that exist between GCC sponsors and western consultants and examines the cultural distance between the key actors. Initial findings suggest the presence to a certain extent of ethnocentricity. Other cultural clashes arise out of a lack of appreciation of the customs, practices and traditions of ‘the Other’, such as the need for avoiding public humiliation and the hierarchal significance rankings. The concept and significance of cultural shock as part of the integration process for new arrivals are considered. Culture shock describes the state of anxiety and frustration resulting from the immersion in a culture distinctly different from one's own. There are potentially substantial project risks associated with underestimating the process of cultural integration. This paper examines two distinct but intertwined issues: the societal and professional culture differences associated with expatriate assignments. A case study examines the cultural congruences between GCC sponsors and American, British and German consultants, over a ten-year cycle. This provides indicators as to which nationalities encountered the most profound cultural issues and the nature of these. GCC megaprojects are typically intensive fast track demanding ventures, where consultant turnover is high. The study finds that building trust-filled relationships is key to successful project team integration and therefore, to successful megaproject execution. Findings indicate that both professional and social inclusion processes have steep learning curves. Traditional risk management practice is to approach any uncertainty in a structured way to mitigate the potential impact on project outcomes. This research highlights cultural risk as a significant factor in the management of GCC megaprojects. These risks arising from high staff turnover typically include loss of project knowledge, delays to the project, cost and disruption in replacing staff. This paper calls for cultural risk to be recognised as an SRF, as the first step to developing risk management strategies, and to reduce staff turnover for western consultants in GCC megaprojects.

Keywords: western consultants in megaprojects, national culture impacts on GCC megaprojects, significant risk factors in megaprojects, professional culture in megaprojects

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443 Public-Private Partnership for Better Protection of Trafficked Victims in Thailand: Case Study on Public Protection and Welfare Center in Cooperation with Jim Thompson Foundation in Occupational Development on Silk Sewing and Tailoring

Authors: Aungkana Kmonpetch

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Protection of trafficked victims and partnership among stakeholders are established as core principles in 5P’ strategies in international and national anti-human trafficking policies. In this article, it is of interest to discuss how the role of public-private partnerships in promoting the occupation development for employment in wage will enhance the better protection for victims of trafficking who affirmatively decide they want a criminal justice intervention, using Thailand as a case. Most of the victims who have accepted to be witness in the criminal justice system have lost income during their absence from work. The analysis of Thailand case is based on two methodological approaches: 1) interview with victims of trafficking, protection authorities, service providers, trainers and teachers, social workers, NGOs, police, prosecutors, business owners and enterprises, ILO, UNDP etc.; 2) create collaborative effort through workshops/consultation meetings in participation of all stakeholders – governmental agencies, private organizations, UN and international agencies. The linking of protection and partnership is anchored in international conventions and human trafficking directives. While this is actually framed as a responsive advantage for 5P strategies of anti-human trafficking – prevention, protection, persecution, punishment, and partnership, in reality, there might have more practical requirements of care and support. The article addresses how the partnership between governmental agencies and private organizations provide opportunities for trafficked victims to engage in high-skilled occupational development such as Silk-Sewing and Tailoring. The discussion is also focused how this approach of capacity building of the trainer for trainee, be enable the trafficked victims to cultivate the practices of high-skilled training to engage them into the business of social enterprise with employment in wage. The partnership coordination draws specifically to two aspects: firstly, to formulate appropriate assistance for promotion and protection of human rights of the trafficked victims in response to the 5P’ strategies of anti-human trafficking policy; secondly, to empower them to settle some economic stability for livelihood opportunity in the country of origin on their return and reintegration. Therefore, they can define how they want to move forward to prevent them at risk of vulnerable situations where they might being trafficked again or going on to work in exploitative conditions. It strengthens proper access to protection and assistance, depending on how the incentive of protection for cooperation is perceived to be and how useful the capacity building in occupation development for employment in wage will be implemented practically both in the host country and in the country of origin. This also brings into question how the victim of trafficking are able to access to the trade of market and are supported the employment opportunity according to the concept of decent work as they are constituted as witnesses. We discuss these issues in the area of a broader literature on social protection, economic security, gender, law, and victimhood.

Keywords: employment opportunity, occupation development, protection for victim of trafficking, public-private partnership

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442 Evaluation of the Performance Measures of Two-Lane Roundabout and Turbo Roundabout with Varying Truck Percentages

Authors: Evangelos Kaisar, Anika Tabassum, Taraneh Ardalan, Majed Al-Ghandour

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The economy of any country is dependent on its ability to accommodate the movement and delivery of goods. The demand for goods movement and services increases truck traffic on highways and inside the cities. The livability of most cities is directly affected by the congestion and environmental impacts of trucks, which are the backbone of the urban freight system. Better operation of heavy vehicles on highways and arterials could lead to the network’s efficiency and reliability. In many cases, roundabouts can respond better than at-level intersections to enable traffic operations with increased safety for both cars and heavy vehicles. Recently emerged, the concept of turbo-roundabout is a viable alternative to the two-lane roundabout aiming to improve traffic efficiency. The primary objective of this study is to evaluate the operation and performance level of an at-grade intersection, a conventional two-lane roundabout, and a basic turbo roundabout for freight movements. To analyze and evaluate the performances of the signalized intersections and the roundabouts, micro simulation models were developed PTV VISSIM. The networks chosen for this analysis in this study are to experiment and evaluate changes in the performance of the movement of vehicles with different geometric and flow scenarios. There are several scenarios that were examined when attempting to assess the impacts of various geometric designs on vehicle movements. The overall traffic efficiency depends on the geometric layout of the intersections, which consists of traffic congestion rate, hourly volume, frequency of heavy vehicles, type of road, and the ratio of major-street versus side-street traffic. The traffic performance was determined by evaluating the delay time, number of stops, and queue length of each intersection for varying truck percentages. The results indicate that turbo-roundabouts can replace signalized intersections and two-lane roundabouts only when the traffic demand is low, even with high truck volume. More specifically, it is clear that two-lane roundabouts are seen to have shorter queue lengths compared to signalized intersections and turbo-roundabouts. For instance, considering the scenario where the volume is highest, and the truck movement and left turn movement are maximum, the signalized intersection has 3 times, and the turbo-roundabout has 5 times longer queue length than a two-lane roundabout in major roads. Similarly, on minor roads, signalized intersections and turbo-roundabouts have 11 times longer queue lengths than two-lane roundabouts for the same scenario. As explained from all the developed scenarios, while the traffic demand lowers, the queue lengths of turbo-roundabouts shorten. This proves that turbo roundabouts perform well for low and medium traffic demand. The results indicate that turbo-roundabouts can replace signalized intersections and two-lane roundabouts only when the traffic demand is low, even with high truck volume. Finally, this study provides recommendations on the conditions under which different intersections perform better than each other.

Keywords: At-grade intersection, simulation, turbo-roundabout, two-lane roundabout

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441 Associated Factors the Safety of the Patient in Hemodialysis Clinics of a Brazilian Municipality: Cross-Sectional Study

Authors: Magda Milleyde de Sousa Lima, Letícia Lima Aguiar, Marina Guerra Martins, Erika Veríssimo Dias Sousa, Lizandra Sampaio de Oliveira, Lívia Moreira Barros, Joselany Áfio Caetano

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Patients with chronic kidney disease are vulnerable to episodes which make the safety of their health vulnerable, mainly due to the treatment process that exposes them to high rates of interventions during hemodialysis sessions. Some factors associated with health care contribute to the risk of death and complications. However, there are a small number of scientific studies evaluating the level of safety of hemodialysis clinics, and the sociodemographic characteristics of patients and professionals associated with this safety. Therefore, the present study aims to examine the level of patient safety in hemodialysis clinics in the Brazilian capital, to identify the sociodemographic and clinical factors of patients and nursing staff associated with the level of safety. This is an observational, descriptive and quantitative research conducted in three hemodialysis clinics placed in the city of Fortaleza-CE, Brazil, from September to November 2019. The sample was formed after a sample calculation for finite inhabitants of correlation with 200 chronic renal patients, 30 nursing technicians and seven nurses. Conventional sampling was used based on the inclusion criteria: being present at the hemodialysis session on the day the researcher performed the data collection and being 18 years of age or older. Participants who presented communication difficulties to listen to and/or answer the sociodemographic and clinical questionnaire were excluded. Two instruments were applied: sociodemographic and clinical characterization form and Chronic Renal Patient Safety Assessment Scale on Hemodialysis (EASPRCH). The data were analyzed using the Kruskal Walls Test for categorical variables and Spearman correlation coefficient for non-categorical variables, using the Statistical Package SPSS version 20.0. The present study respected the ethical and legal principles determined by resolution 466/2012 of the National Health Council, under the approval of the Ethics and Research Committee with an opinion number: 3,255,635. The results showed that a hemodialysis clinic presented unsafe care practices of 32 points in the EASPRCH (p=0.001). A statistical association was identified between the level of safety and the variables of the patients: level of education (p=0.018), family income (p=0.049), type of employment (p=0.012), venous access site (p=0.009), use of medication during the session (p=0.008) and time of hemodialysis (p=0.002). When evaluating the profile of nurses, a statistical association was evidenced between the level of safety with the variables: marital status (p=0.000), race (p=0.017), schooling (p= 0.000), income (p=0.013), age (p=0.000), clinic workload (p=0.000), time working with hemodialysis (p=0.000), time working in the clinic (p= 0.007) and clinic sizing (p=0.000). In order, the sociodemographic factors of nursing technicians associated with the level of patient safety were: race (p= 0.001) and weekly workload at (p=0.010). Therefore, it is concluded that there is a non-conformity in the level of patient safety in one of the clinics studied and, that sociodemographic and clinical factors of patients and health professionals corroborate the level of safety of the health unit.

Keywords: hemodialysis, nursing, patient safety, quality improvement

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440 Telogen Effluvium: A Modern Hair Loss Concern and the Interventional Strategies

Authors: Chettyparambil Lalchand Thejalakshmi, Sonal Sabu Edattukaran

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Hair loss is one of the main issues that contemporary society is dealing with. It can be attributable to a wide range of factors, listing from one's genetic composition and the anxiety we experience on a daily basis. Telogen effluvium [TE] is a condition that causes temporary hair loss after a stressor that might shock the body and cause the hair follicles to temporarily rest, leading to hair loss. Most frequently, women are the ones who bring up these difficulties. Extreme illness or trauma, an emotional or important life event, rapid weight loss and crash dieting, a severe scalp skin problem, a new medication, or ceasing hormone therapy are examples of potential causes. Men frequently do not notice hair thinning with time, but women with long hair may be easily identified when shedding, which can occasionally result in bias because women tend to be more concerned with aesthetics and beauty standards of the society, and approach frequently with the concerns .The woman, who formerly possessed a full head of hair, is worried about the hair loss from her scalp . There are several cases of hair loss reported every day, and Telogen effluvium is said to be the most prevalent one of them all without any hereditary risk factors. While the patient has loss in hair volume, baldness is not the result of this problem . The exponentially growing Dermatology and Aesthetic medical division has discovered that this problem is the most common and also the easiest to cure since it is feasible for these people to regrow their hair, unlike those who have scarring alopecia, in which the follicle itself is damaged and non-viable. Telogen effluvium comes in two different forms: acute and chronic. Acute TE occurs in all the age groups with a hair loss of less than three months, while chronic TE is more common in those between the ages of 30 and 60 with a hair loss of more than six months . Both kinds are prevalent throughout all age groups, regardless of the predominance. It takes between three and six months for the lost hair to come back, although this condition is readily reversed by eliminating stresses. After shedding their hair, patients frequently describe having noticeable fringes on their forehead. The current medical treatments for this condition include topical corticosteroids, systemic corticosteroids, minoxidil and finasteride, CNDPA (caffeine, niacinamide, panthenol, dimethicone, and an acrylate polymer) .Individual terminal hair growth was increased by 10% as a result of the innovative intervention CNDPA. Botulinum Toxin A, Scalp Micro Needling, Platelet Rich Plasma Therapy [PRP], and sessions with Multivitamin Mesotherapy Injections are some recently enhanced techniques with partially or completely reversible hair loss. Also, it has been shown that supplements like Nutrafol and Biotin are producing effective outcomes. There is virtually little evidence to support the claim that applying sulfur-rich ingredients to the scalp, such as onion juice, can help TE patients' hair regenerate.

Keywords: dermatology, telogen effluvium, hair loss, modern hair loass treatments

Procedia PDF Downloads 74
439 Managing Human-Wildlife Conflicts Compensation Claims Data Collection and Payments Using a Scheme Administrator

Authors: Eric Mwenda, Shadrack Ngene

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Human-wildlife conflicts (HWCs) are the main threat to conservation in Africa. This is because wildlife needs overlap with those of humans. In Kenya, about 70% of wildlife occurs outside protected areas. As a result, wildlife and human range overlap, causing HWCs. The HWCs in Kenya occur in the drylands adjacent to protected areas. The top five counties with the highest incidences of HWC are Taita Taveta, Narok, Lamu, Kajiado, and Laikipia. The common wildlife species responsible for HWCs are elephants, buffaloes, hyenas, hippos, leopards, baboons, monkeys, snakes, and crocodiles. To ensure individuals affected by the conflicts are compensated, Kenya has developed a model of HWC compensation claims data collection and payment. We collected data on HWC from all eight Kenya Wildlife Service (KWS) Conservation Areas from 2009 to 2019. Additional data was collected from stakeholders' consultative workshops held in the Conservation Areas and a literature review regarding payment of injuries and ongoing insurance schemes being practiced in areas. This was followed by the description of the claims administration process and calculation of the pricing of the compensation claims. We further developed a digital platform for data capture and processing of all reported conflict cases and payments. Our product recognized four categories of HWC (i.e., human death and injury, property damage, crop destruction, and livestock predation). Personal bodily injury and human death were provided based on the Continental Scale of Benefits. We proposed a maximum of Kenya Shillings (KES) 3,000,000 for death. Medical, pharmaceutical, and hospital expenses were capped at a maximum of KES 150,000, as well as funeral costs at KES 50,000. Pain and suffering were proposed to be paid for 12 months at the rate of KES 13,500 per month. Crop damage was to be based on farm input costs at a maximum of KES 150,000 per claim. Livestock predation leading to death was based on Tropical Livestock Unit (TLU), which is equivalent to KES 30,000, whick includes Cattle (1 TLU = KES 30,000), Camel (1.4 TLU = KES 42,000), Goat (0.15 TLU = 4,500), Sheep (0.15 TLU = 4,500), and Donkey (0.5 TLU = KES 15,000). Property destruction (buildings, outside structures and harvested crops) was capped at KES 150,000 per any one claim. We conclude that it is possible to use an administrator to collect data on HWC compensation claims and make payments using technology. The success of the new approach will depend on a piloting program. We recommended that a pilot scheme be initiated for eight months in Taita Taveta, Kajiado, Baringo, Laikipia, Narok, and Meru Counties. This will test the claims administration process as well as harmonize data collection methods. The results of this pilot will be crucial in adjusting the scheme before country-wide roll out.

Keywords: human-wildlife conflicts, compensation, human death and injury, crop destruction, predation, property destruction

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438 Theoretical-Methodological Model to Study Vulnerability of Death in the Past from a Bioarchaeological Approach

Authors: Geraldine G. Granados Vazquez

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Every human being is exposed to the risk of dying; wherein some of them are more susceptible than others depending on the cause. Therefore, the cause could be the hazard to die that a group or individual has, making this irreversible damage the condition of vulnerability. Risk is a dynamic concept; which means that it depends on the environmental, social, economic and political conditions. Thus vulnerability may only be evaluated in terms of relative parameters. This research is focusing specifically on building a model that evaluate the risk or propensity of death in past urban societies in connection with the everyday life of individuals, considering that death can be a consequence of two coexisting issues: hazard and the deterioration of the resistance to destruction. One of the most important discussions in bioarchaeology refers to health and life conditions in ancient groups; the researchers are looking for more flexible models that evaluate these topics. In that way, this research proposes a theoretical-methodological model that assess the vulnerability of death in past urban groups. This model pretends to be useful to evaluate the risk of death, considering their sociohistorical context, and their intrinsic biological features. This theoretical and methodological model, propose four areas to assess vulnerability. The first three areas use statistical methods or quantitative analysis. While the last and fourth area, which corresponds to the embodiment, is based on qualitative analysis. The four areas and their techniques proposed are a) Demographic dynamics. From the distribution of age at the time of death, the analysis of mortality will be performed using life tables. From here, four aspects may be inferred: population structure, fertility, mortality-survival, and productivity-migration, b) Frailty. Selective mortality and heterogeneity in frailty can be assessed through the relationship between characteristics and the age at death. There are two indicators used in contemporary populations to evaluate stress: height and linear enamel hypoplasias. Height estimates may account for the individual’s nutrition and health history in specific groups; while enamel hypoplasias are an account of the individual’s first years of life, c) Inequality. Space reflects various sectors of society, also in ancient cities. In general terms, the spatial analysis uses measures of association to show the relationship between frail variables and space, d) Embodiment. The story of everyone leaves some evidence on the body, even in the bones. That led us to think about the dynamic individual's relations in terms of time and space; consequently, the micro analysis of persons will assess vulnerability from the everyday life, where the symbolic meaning also plays a major role. In sum, using some Mesoamerica examples, as study cases, this research demonstrates that not only the intrinsic characteristics related to the age and sex of individuals are conducive to vulnerability, but also the social and historical context that determines their state of frailty before death. An attenuating factor for past groups is that some basic aspects –such as the role they played in everyday life– escape our comprehension, and are still under discussion.

Keywords: bioarchaeology, frailty, Mesoamerica, vulnerability

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437 Transforming Challenges of Urban and Peri-Urban Agriculture into Opportunities for Urban Food Security in India

Authors: G. Kiran Kumar, K. Padmaja

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The rise of urban and peri-urban agriculture (UPA) is an important urban phenomenon that needs to be well understood before we pronounce a verdict whether it is beneficial or not. The challenge of supply of safe and nutritious food is faced by urban inhabitants. The definition of urban and peri-urban varies from city to city depending on the local policies framed with a view to bring regulated urban habitations as part of governance. Expansion of cities and the blurring of boundaries between urban and rural areas make it difficult to define peri-urban agriculture. The problem is further exacerbated by the fact that definition adopted in one region may not fit in the other. On the other hand the proportion of urban population is on the rise vis-à-vis rural. The rise of UPA does not promise that the food requirements of cities can be entirely met from this practice, since availability of enormous amounts of spaces on rooftops and vacant plots is impossible for raising crops. However, UPA reduces impact of price volatility, particularly for vegetables, which relatively have a longer shelf life. UPA improves access to fresh, nutritious and safe food for the urban poor. UPA provides employment to food handlers and traders in the supply chain. UPA can pose environmental and health risks from inappropriate agricultural practices; increased competition for land, water and energy; alter the ecological landscape and make it vulnerable to increased pollution. The present work is based on case studies in peri-urban agriculture in Hyderabad, India and relies on secondary data. This paper tries to analyze the need for more intensive production technologies without affecting the environment. An optimal solution in terms of urban-rural linkages has to be devised. There is a need to develop a spatial vision and integrate UPA in urban planning in a harmonious manner. Zoning of peri-urban areas for agriculture, milk and poultry production is an essential step to preserve the traditional nurturing character of these areas. Urban local bodies in conjunction with Departments of Agriculture and Horticulture can provide uplift to existing UPA models, without which the UPA can develop into a haphazard phenomenon and add to the increasing list of urban challenges. Land to be diverted for peri-urban agriculture may render the concept of urban and peri-urban forestry ineffective. This paper suggests that UPA may be practiced for high value vegetables which can be cultivated under protected conditions and are better resilient to climate change. UPA can provide models for climate resilient agriculture in urban areas which can be replicated in rural areas. Production of organic farm produce is another option for promote UPA owing to the proximity to informed consumers and access to markets within close range. Waste lands in peri-urban areas can be allotted to unemployed rural youth with the support of Urban Local Bodies (ULBs) and used for UPA. This can serve the purposes of putting wastelands to food production, enhancing employment opportunities and enhancing access to fresh produce for urban consumers.

Keywords: environment, food security, urban and peri-urban agriculture, zoning

Procedia PDF Downloads 300
436 Correlation between the Levels of Some Inflammatory Cytokines/Haematological Parameters and Khorana Scores of Newly Diagnosed Ambulatory Cancer Patients

Authors: Angela O. Ugwu, Sunday Ocheni

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Background: Cancer-associated thrombosis (CAT) is a cause of morbidity and mortality among cancer patients. Several risk factors for developing venous thromboembolism (VTE) also coexist with cancer patients, such as chemotherapy and immobilization, thus contributing to the higher risk of VTE in cancer patients when compared to non-cancer patients. This study aimed to determine if there is any correlation between levels of some inflammatory cytokines/haematological parameters and Khorana scores of newly diagnosed chemotherapy naïve ambulatory cancer patients (CNACP). Methods: This was a cross-sectional analytical study carried out from June 2021 to May 2022. Eligible newly diagnosed cancer patients 18 years and above (case group) were enrolled consecutively from the adult Oncology Clinics of the University of Nigeria Teaching Hospital, Ituku/Ozalla (UNTH). The control group was blood donors at UNTH Ituku/Ozalla, Enugu blood bank, and healthy members of the Medical and Dental Consultants Association of Nigeria (MDCAN), UNTH Chapter. Blood samples collected from the participants were assayed for IL-6, TNF-Alpha, and haematological parameters such as haemoglobin, white blood cell count (WBC), and platelet count. Data were entered into an Excel worksheet and were then analyzed using Statistical Package for Social Sciences (SPSS) computer software version 21.0 for windows. A P value of < 0.05 was considered statistically significant. Results: A total of 200 participants (100 cases and 100 controls) were included in the study. The overall mean age of the participants was 47.42 ±15.1 (range 20-76). The sociodemographic characteristics of the two groups, including age, sex, educational level, body mass index (BMI), and occupation, were similar (P > 0.05). Following One Way ANOVA, there were significant differences between the mean levels of interleukin-6 (IL-6) (p = 0.036) and tumor necrotic factor-α (TNF-α) (p = 0.001) in the three Khorana score groups of the case group. Pearson’s correlation analysis showed a significant positive correlation between the Khorana scores and IL-6 (r=0.28, p = 0.031), TNF-α (r= 0.254, p= 0.011), and PLR (r= 0.240, p=0.016). The mean serum levels of IL-6 were significantly higher in CNACP than in the healthy controls [8.98 (8-12) pg/ml vs. 8.43 (2-10) pg/ml, P=0.0005]. There were also significant differences in the mean levels of the haemoglobin (Hb) level (P < 0.001)); white blood cell (WBC) count ((P < 0.001), and platelet (PL) count (P = 0.005) between the two groups of participants. Conclusion: There is a significant positive correlation between the serum levels of IL-6, TNF-α, and PLR and the Khorana scores of CNACP. The mean serum levels of IL-6, TNF-α, PLR, WBC, and PL count were significantly higher in CNACP than in the healthy controls. Ambulatory cancer patients with high-risk Khorana scores may benefit from anti-inflammatory drugs because of the positive correlation with inflammatory cytokines. Recommendations: Ambulatory cancer patients with 2 Khorana scores may benefit from thromboprophylaxis since they have higher Khorana scores. A multicenter study with a heterogeneous population and larger sample size is recommended in the future to further elucidate the relationship between IL-6, TNF-α, PLR, and the Khorana scores among cancer patients in the Nigerian population.

Keywords: thromboprophylaxis, cancer, Khorana scores, inflammatory cytokines, haematological parameters

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435 Maternal Risk Factors Associated with Low Birth Weight Neonates in Pokhara, Nepal: A Hospital Based Case Control Study

Authors: Dipendra Kumar Yadav, Nabaraj Paudel, Anjana Yadav

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

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

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434 Understanding Awareness, Agency and Autonomy of Mothers and Potential of Digital Technology in Expanding Maternal Health Information Access: A Survey of Mothers in Urban India

Authors: Sumiti Saharan, Pallav Patankar, Lily W. Lee

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Understanding the health-seeking behaviors and attitudes of women towards maternal health in the context of gender roles and family dynamics is tremendously crucial for designing effective and impactful interventions aimed at improving maternal and child health outcomes. Further, as the digital world becomes more accessible and affordable, it is imperative to scope the potential of digital technology in enabling access to maternal health information in different socio-economic groups (SEGs). In the summer of 2017, we conducted a study with 500 women across different SEGs in urban India who were pregnant or had had a delivery in the last year. The study was undertaken to assess their maternal health information seeking behavior with a particular focus on probing their use of digital technology for health-related information. The study also measured women's decision-making autonomy in the context of maternal health, awareness of their rights to quality and respectful maternal healthcare, and agency to voice their rights. We probed the impact of key variables including education, age, and socioeconomic status on all outcome variables. In terms of health-seeking behaviors, we found that women heavily relied on medical professionals and/or their mothers and mothers-in-law for all maternal health advice. Digital adoption was found to be high across all SEGs, with around 70% of women from all populations using the internet several times a week. On the other hand, use of the internet for both accessing maternal health information and choosing maternity hospitals were both significantly dependent on SEG. The key reasons reported for not using the internet for health purposes were lack of awareness and lack of trust on content accuracy. Decisions around health practices and type of delivery were found to be jointly made by women and other family members. Almost all women reported their husbands to play a key role in all maternal health decisions and for decisions with a clear financial implication like choice of hospital for delivery, husbands were reported to be the sole decision maker by a majority of women. The agency of women was also found to be low in interactions with maternal healthcare providers with a third of respondents not comfortable with voicing their opinions and preferences to their doctors. Interestingly, we find that this relatively low agency was prominent in both lower middle class and middle-class SEGs. Recognition of the sociocultural determinants of behavior is the first step in developing actionable strategies for improving maternal health outcomes. Our study quantifies the agency and autonomy of women in urban India and the variables that impact them. Our findings emphasize the value of gender normative approaches that factor in the key role husbands play in guiding maternal health decisions. They also highlight the power of digital approaches for catalyzing access to maternal health information. These insights into the attitude and behaviors of mothers in context of their sociocultural environments—and their relationship with digital technology—can help pave the way towards designing effective, scalable maternal and child health programs in developing nations like India.

Keywords: access to healthcare information, behavior, digital health, maternal health

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433 Medical Dressing Induced Digital Ischemia in Patient with Congenital Insensitivity to Pain and Anhidrosis

Authors: Abdulwhab Alotaibi, Abdullah Alzahrani, Ziyad Bokhari, Abdulelah Alghamdi

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First described in 1975 by Dr. Miller, Medical dressings are uncommon but possible cause of hand digital ischemia due the tourniquet-like effect. The incident of this complication has been reported across wide range of age-groups, yet it seems like that the pediatric population are specifically vulnerable. Multiple dressing types were reported to have caused ischemic injury, such as elastic wrap, tubular gauze, and self-adherent dressings. We present a case of medical dressing induced digital ischemia in patient with Congenital insensitivity to pain and anhidrosis (CIPA), which further challenge the discovery of the condition. An 8-year-old girl known case of CIPA. Brought by her mother to the ER after nail bed injury, which she managed by application of elastic wrap that was left for 24 hours. When the mother found out she immediately removed the elastic band, and noticed the fingertip was black and cold with tense bullae. The color then changed later when she arrived to the ER to dark purple with bluish discoloration on the tip. On examination there was well demarcated tense bullae on the distal right fifth finger. Neurovascular intact, pulse oximetry on distal digit 100%, capillary refill time was delayed. She was seen under Plastic surgery and conservative management recommended, and patient was discharged with safety netting. Two days later the patient came as follow-up visit at which her condition demonstrated significant improvement, the bullae has since ruptured leaving behind sloughed skin, capillary refill and pulse oximetry were both within normal limits, sensory function couldn’t be assessed but her motor function and ROM were normal, topical bacitracin and bandage dressings were applied for the eroded skin. Patient was scheduled for a follow-up in 2 weeks. Preventatively it’s advisable to avoid the commonly implicated dressings such as elastic, tubular gauze or self-adherent wraps in hand or digital injuries when possible, but in cases where the use of these dressings is of necessity the appropriate precautions must be taken, Dr. Makarewich proposed the following 5 measures to help minimize the incidence of the injury: 1-Unwrapping 12 inches of the dressing before rolling the injured finger. 2-Wrapping from distal to proximal with minimal tension to avoid vascular embarrassment. 3-The use of 5-25 inch to overlap the entire wrap. 4-Maintaining light pressure over the wrap to allow adherence of the dressing. 5-Minimization of the number of layers used to wrap the affected digit. Also assessing the capillary refill after the application can help in determining the patency of the supplying blood vessels. It’s also important to selectively determine if the patient is a candidate for conservative management, as tailored approach can help in maximizing the positive outcomes for our patients.

Keywords: congenital insensitivity to pain, digital ischemia, medical dressing, conservative management

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432 Optimal Control of Generators and Series Compensators within Multi-Space-Time Frame

Authors: Qian Chen, Lin Xu, Ping Ju, Zhuoran Li, Yiping Yu, Yuqing Jin

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The operation of power grid is becoming more and more complex and difficult due to its rapid development towards high voltage, long distance, and large capacity. For instance, many large-scale wind farms have connected to power grid, where their fluctuation and randomness is very likely to affect the stability and safety of the grid. Fortunately, many new-type equipments based on power electronics have been applied to power grid, such as UPFC (Unified Power Flow Controller), TCSC (Thyristor Controlled Series Compensation), STATCOM (Static Synchronous Compensator) and so on, which can help to deal with the problem above. Compared with traditional equipment such as generator, new-type controllable devices, represented by the FACTS (Flexible AC Transmission System), have more accurate control ability and respond faster. But they are too expensive to use widely. Therefore, on the basis of the comparison and analysis of the controlling characteristics between traditional control equipment and new-type controllable equipment in both time and space scale, a coordinated optimizing control method within mutil-time-space frame is proposed in this paper to bring both kinds of advantages into play, which can better both control ability and economical efficiency. Firstly, the coordination of different space sizes of grid is studied focused on the fluctuation caused by large-scale wind farms connected to power grid. With generator, FSC (Fixed Series Compensation) and TCSC, the coordination method on two-layer regional power grid vs. its sub grid is studied in detail. The coordination control model is built, the corresponding scheme is promoted, and the conclusion is verified by simulation. By analysis, interface power flow can be controlled by generator and the specific line power flow between two-layer regions can be adjusted by FSC and TCSC. The smaller the interface power flow adjusted by generator, the bigger the control margin of TCSC, instead, the total consumption of generator is much higher. Secondly, the coordination of different time sizes is studied to further the amount of the total consumption of generator and the control margin of TCSC, where the minimum control cost can be acquired. The coordination method on two-layer ultra short-term correction vs. AGC (Automatic Generation Control) is studied with generator, FSC and TCSC. The optimal control model is founded, genetic algorithm is selected to solve the problem, and the conclusion is verified by simulation. Finally, the aforementioned method within multi-time-space scale is analyzed with practical cases, and simulated on PSASP (Power System Analysis Software Package) platform. The correctness and effectiveness are verified by the simulation result. Moreover, this coordinated optimizing control method can contribute to the decrease of control cost and will provide reference to the following studies in this field.

Keywords: FACTS, multi-space-time frame, optimal control, TCSC

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431 Lessons Learned from Implementation of Remote Pregnant and Newborn Care Service for Vulnerable Women and Children During COVID-19 and Political Crisis in Myanmar

Authors: Wint Wint Thu, Htet Ko Ko Win, Myat Mon San, Zaw Lin Tun, Nandar Than Aye, Khin Nyein Myat, Hayman Nyo Oo, Nay Aung Lin, Kusum Thapa, Kyaw Htet Aung

Abstract:

Background: In Myanmar, the intense political instability happened to start in Feb-2021, while the COVID-19 pandemic waves are also threatening the public health system, which subsequently led to severe health sector crisis, including difficulties in accessing maternal and newborn health care for vulnerable women and children. The Remote Pregnant and Newborn Care (RPNC) uses a telehealth approach United States Agency for International Development (USAID)-funded Essential Health Project. Implementation: The Remote Pregnant and Newborn Care (RPNC) service has adapted to the MNCH needs of vulnerable pregnant women and was implemented to mitigate the risk of limited access to essential quality MNH care in Yangon, Myanmar, under women, and the project trained 13 service providers on a telehealth care package for pregnancy and newborn developed Jhpiego to ensure understanding of evidence-based MNCH care practices. The phone numbers of the pregnant women were gathered through the preexisting and functioning community volunteers, who reach the most vulnerable pregnant women in the project's targeted area. A total of 212 pregnant women have been reached by service providers for RPNC during the implementation period. The trained service providers offer quality antenatal and postnatal care, including newborn care, via telephone calls. It includes 24/7 incoming calls and time-allotted outgoing calls to the pregnant women during antenatal and postnatal periods, including the newborn care. The required data were collected daily in time with the calls, and the quality of the medical services is made assured with the track of the calls, ensuring data privacy and patient confidentiality. Lessons learned: The key lessons are 1) cost-effectiveness: RPNC service could reduce out of pocket expenditure of pregnant women as it only costs 1.6 United States dollars (USD) per one telehealth call while it costs 8 to 10 USD per one time in-person care service at private service providers, including transportation cost, 2) network of care: telehealth call could not replace the in-person antenatal and postnatal care services, and integration of telehealth calls with in-person care by local healthcare providers with the support of the community is crucial for accessibility to essential MNH services by poor and vulnerable women, and 3) sharing information on health access points: most of the women seem to have financial barriers in accessing private health facilities while public health system collapse and telehealthcare could provide information on low-cost facilities and connect women to relevant health facilities. These key lessons are important for future efforts regarding the implementation of remote pregnancy and newborn care in Myanmar, especially during the political crisis and COVID-19 pandemic situation.

Keywords: telehealth, accessibility, maternal care, newborn care

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430 Vieira Da Silva's Tiles at Universidade Federal Rural Do Rio de Janeiro: A Conservation and Restoration Project

Authors: Adriana Anselmo Oliveira

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The present project showcases a tile work from the Franco-Portuguese artist Maria Helena Vieira da Silva (1908-1992). It is a set of 8 panels composed of figurative and geometric tiles, with extra tiles framing nearby doors and windows in a study room in the (UFRRJ, Universidade Federal Rural do Rio de Janeiro). The aforementioned work was created between 1942 and 1943, during the artist's 6 year exile in the Brazilian city. This one-of-a-kind tileset was designed and made by Vieira da Silva between 1942 and 1943. Over the years, several units were lost, which led to their replacement in the nineties. However, these replacements don't do justice to the original work of art. In 2007, a project was initiated to fully repair and maintain the set. Three panels are removed and restored, but the project is halted. To this day, the three fully restored panels remain in boxes. In 2016 a new restoration project is submitted by the (Faculdade de Belas Artes da Universidade de Lisboa) in collaboration with de (Fundacão Árpád Szenes-Vieira da Silva). There are many varied opinions on restoring and conserving older pieces of art, however, we have the moral duty to safeguard the original materials used by the artist along with the artists original vision and also to care for the future generations of students who will use the space in which the tile-work was inserted. Many tiles have been replaced by white tiles, tiles with a divergent colour pallet and technique, and in a few cases, the incorrect place or way around. These many factors make it increasingly difficult to maintain the artists original vision and destroy and chance of coherence within the artwork itself. The conservative technician cannot make new images to fill the empty spaces or mark the remaining images with their own creative input. with reliable photographic documentation that can provide us with the necessary vision to allow us to proceed with an accurate reconstruction, we have the obligation to proceed and return the piece of art to its true form, as in its current state, it is impossible to maintain its original glory. Using the information we have, we must find a way to differentiate the original tiles from the reconstructions in order to recreate and reclaim the original message from the artist. The objective of this project is to understand the significance of tiles in Vieira da Silva's art as well as the influence they had on the artist's pictorial language since the colour definition on tile work is vastly different from the painting process as the materials change during their merger. Another primary goal is to understand what the previous interventions achieved besides increasing the artworks durability. The main objective is to submit a proposal that can salvage the artist's visual intention and supports it for posteriority. In summary, this proposal goes further than the usual conservative interventions as it intends to recreate the original artistic worth, prioritising the aesthetics and keeping its soul alive.

Keywords: Vieira da Silva, tiles, conservation, restoration

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