Search results for: primary school children
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 9065

Search results for: primary school children

905 Age-Related Health Problems and Needs of Elderly People Living in Rural Areas in Poland

Authors: Anna Mirczak

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Introduction: In connection with the aging of the population and the increase in the number of people with chronic illnesses, the priority objective for public health has become not only lengthening life, but also improving quality of life in older persons, as well as maintenance of their relative independence and active participation in social life. The most important determinant of a person’s quality of life is health. According to the literature, older people with chronic illness who live in rural settings are at greater risk for poor outcomes than their urban counterparts. Furthermore research characterizes the rural elderly as having a higher incidence of sickness, dysfunction, disability, restricted mobility, and acute and chronic conditions than their urban citizens. It is dictated by the overlapping certain specific socio-economic factors typical for rural areas which include: social and geography exclusion, limited access to health care centers, and low socioeconomic status. Aim of the study: The objective of this study was to recognize health status and needs of older people living in selected rural areas in Poland and evaluate the impacts of working in the farm on their health status. Material and methods: The study was performed personally, using interviews based on the structural questionnaires, during the period from March 2011 to October 2012. The group of respondents consisted 203 people aged 65 years and over living in selected rural areas in Poland. The analysis of collected research material was performed using the statistical package SPSS 19 for Windows. The level of significance for the tested the hypotheses assumed value of 0.05. Results: The mean age of participants was 75,5 years (SD=5,7) range from 65 to 94 years. Most of the interviewees had children (89.2%) and grandchildren (83.7) and lived mainly with family members (75.9%) mostly in double (46.8%) and triple (20.8%) household. The majority of respondents (71,9%) were physical working on the farm. At the time of interview, each of the respondents reported that they had been diagnosed with at least one chronic diseases by their GP. The most common were: hypertension (67,5%), osteoarthritis (44,8%), atherosclerosis (43,3%), cataract (40,4%), arrhythmia (28,6%), diabetes mellitus (19,7%) and stomach or duodenum ulcer diseases (17,2%).The number of diseases occurring of the sample was dependent on gender and age. Significant associations were observed between working on the farm and frequency of occurrence cardiovascular diseases, the gastrointestinal tract dysfunction and sensory disorders. Conclusions: The most common causes of disability among older citizens were: chronic diseases, malnutrition and complaints about access to health services (especially to cardiologist and an ophthalmologist). Health care access and health status are a particular concern in rural areas where the population is older, has lower education and income levels, and is more likely to be living in medically underserved areas than is the case in urban areas.

Keywords: ageing, health status, older people, rural

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904 Efficacy and Safety of Updated Target Therapies for Treatment of Platinum-Resistant Recurrent Ovarian Cancer

Authors: John Hang Leung, Shyh-Yau Wang, Hei-Tung Yip, Fion, Ho Tsung-chin, Agnes LF Chan

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Objectives: Platinum-resistant ovarian cancer has a short overall survival of 9–12 months and limited treatment options. The combination of immunotherapy and targeted therapy appears to be a promising treatment option for patients with ovarian cancer, particularly to patients with platinum-resistant recurrent ovarian cancer (PRrOC). However, there are no direct head-to-head clinical trials comparing their efficacy and toxicity. We, therefore, used a network to directly and indirectly compare seven newer immunotherapies or targeted therapies combined with chemotherapy in platinum-resistant relapsed ovarian cancer, including antibody-drug conjugates, PD-1 (Programmed death-1) and PD-L1 (Programmed death-ligand 1), PARP (Poly ADP-ribose polymerase) inhibitors, TKIs (Tyrosine kinase inhibitors), and antiangiogenic agents. Methods: We searched PubMed (Public/Publisher MEDLINE), EMBASE (Excerpta Medica Database), and the Cochrane Library electronic databases for phase II and III trials involving PRrOC patients treated with immunotherapy or targeted therapy plus chemotherapy. The quality of included trials was assessed using the GRADE method. The primary outcomes compared were progression-free survival, the secondary outcomes were overall survival and safety. Results: Seven randomized controlled trials involving a total of 2058 PRrOC patients were included in this analysis. Bevacizumab plus chemotherapy showed statistically significant differences in PFS (Progression-free survival) but not OS (Overall survival) for all interested targets and immunotherapy regimens; however, according to the heatmap analysis, bevacizumab plus chemotherapy had a statistically significant risk of ≥grade 3 SAEs (Severe adverse effects), particularly hematological severe adverse events (neutropenia, anemia, leukopenia, and thrombocytopenia). Conclusions: Bevacizumab plus chemotherapy resulted in better PFS as compared with all interested regimens for the treatment of PRrOC. However, statistical differences in SAEs as bevacizumab plus chemotherapy is associated with a greater risk for hematological SAE.

Keywords: platinum-resistant recurrent ovarian cancer, network meta-analysis, immune checkpoint inhibitors, target therapy, antiangiogenic agents

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903 Analysis on the Converged Method of Korean Scientific and Mathematical Fields and Liberal Arts Programme: Focusing on the Intervention Patterns in Liberal Arts

Authors: Jinhui Bak, Bumjin Kim

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The purpose of this study is to analyze how the scientific and mathematical fields (STEM) and liberal arts (A) work together in the STEAM program. In the future STEAM programs that have been designed and developed, the humanities will act not just as a 'tool' for science technology and mathematics, but as a 'core' content to have an equivalent status. STEAM was first introduced to the Republic of Korea in 2011 when the Ministry of Education emphasized fostering creative convergence talent. Many programs have since been developed under the name STEAM, but with the majority of programs focusing on technology education, arts and humanities are considered secondary. As a result, arts is most likely to be accepted as an option that can be excluded from the teachers who run the STEAM program. If what we ultimately pursue through STEAM education is in fostering STEAM literacy, we should no longer turn arts into a tooling area for STEM. Based on this consciousness, this study analyzed over 160 STEAM programs in middle and high schools, which were produced and distributed by the Ministry of Education and the Korea Science and Technology Foundation from 2012 to 2017. The framework of analyses referenced two criteria presented in the related prior studies: normative convergence and technological convergence. In addition, we divide Arts into fine arts and liberal arts and focused on Korean Language Course which is in liberal arts and analyzed what kind of curriculum standards were selected, and what kind of process the Korean language department participated in teaching and learning. In this study, to ensure the reliability of the analysis results, we have chosen to cross-check the individual analysis results of the two researchers and only if they are consistent. We also conducted a reliability check on the analysis results of three middle and high school teachers involved in the STEAM education program. Analyzing 10 programs selected randomly from the analyzed programs, Cronbach's α .853 showed a reliable level. The results of this study are summarized as follows. First, the convergence ratio of the liberal arts was lowest in the department of moral at 14.58%. Second, the normative convergence is 28.19%, which is lower than that of the technological convergence. Third, the language and achievement criteria selected for the program were limited to functional areas such as listening, talking, reading and writing. This means that the convergence of Korean language departments is made only by the necessary tools to communicate opinions or promote scientific products. In this study, we intend to compare these results with the STEAM programs in the United States and abroad to explore what elements or key concepts are required for the achievement criteria for Korean language and curriculum. This is meaningful in that the humanities field (A), including Korean, provides basic data that can be fused into 'equivalent qualifications' with science (S), technical engineering (TE) and mathematics (M).

Keywords: Korean STEAM Programme, liberal arts, STEAM curriculum, STEAM Literacy, STEM

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902 Teaching for Social Justice: Towards Education for Sustainable Development

Authors: Nashwa Moheyeldine

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Education for sustainable development (ESD) aims to preserve the rights of the present and future generations as well as preserving the globe, both humans and nature. ESD should aim not only to bring about consciousness of the current and future issues, but also to foster student agency to bring about change at schools, communities and nations. According to the Freirian concept of conscientização, (conscientization) — “learning to perceive social, political, and economic contradictions, and to take action against the oppressive elements of reality”, education aims to liberate people to understand and act upon their worlds. Social justice is greatly intertwined with a nation’s social, political and economic rights, and thus, should be targeted through ESD. “Literacy researchers have found that K-12 students who engage in social justice inquiries develop vital academic knowledge and skills, critical understandings about oppression in the world, and strong dispositions to continue working toward social justice beyond the initial inquiries they conduct”. Education for social justice greatly equips students with the critical thinking skills and sense of agency, that are required for responsible decision making that would ensure a sustainable world. In fact teaching for social justice is intersecting with many of the pedagogies such as multicultural education, cultural relevant pedagogy, education for sustainable development, critical theory pedagogy, (local and global) citizenship education, all of which aim to prepare students for awareness, responsibility and agency. Social justice pedagogy has three specific goals, including helping students develop 1) a sociopolitical consciousness - an awareness of the symbiotic relationship between the social and political factors that affect society, 2) a sense of agency, the freedom to act on one’s behalf and to feel empowered as a change agent, and 3) positive social and cultural identities. The keyword to social justice education is to expose the realities to the students, and challenge the students not only to question , but also to change. Social justice has been usually discussed through the subjects of history and social sciences, however, an interdisciplinary approach is essential to enhance the students’ understanding of their world. Teaching social justice through various subjects is also important, as it make students’ learning relevant to their lives. The main question that this paper seeks to answer is ‘How could social justice be taught through different subjects and tools, such as mathematics, literature through story-telling, geography, and service learning will be shown in this paper. Also challenges to education for social justice will be described. Education is not a neutral endeavor, but is either oriented toward the cause of liberation or in support of domination. In fact , classrooms can be “a microcosm of the emancipatory societies we seek to encourage”, education for the 21st century should be relevant to students' lives where it exposes life's realities to them. Education should also provide students with the basics of school subjects with the bigger goal of helping them make the world a better, more just place to live in.

Keywords: teaching for social justice, student agency, citizenship education, education

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901 Comprehensive Geriatric Assessments: An Audit into Assessing and Improving Uptake on Geriatric Wards at King’s College Hospital, London

Authors: Michael Adebayo, Saheed Lawal

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The Comprehensive Geriatric Assessment (CGA) is the multidimensional tool used to assess elderly, frail patients either on admission to hospital care or at a community level in primary care. It is a tool designed with the aim of using a holistic approach to managing patients. A Cochrane review of CGA use in 2011 found that the likelihood of being alive and living in their own home rises by 30% post-discharge. RCTs have also discovered 10–15% reductions in readmission rates and reductions in institutionalization, and resource use and costs. Past audit cycles at King’s College Hospital, Denmark Hill had shown inconsistent evidence of CGA completion inpatient discharge summaries (less than 50%). Junior Doctors in the Health and Ageing (HAU) wards have struggled to sustain the efforts of past audit cycles due to the quick turnover in staff (four-month placements for trainees). This 7th cycle created a multi-faceted approach to solving this problem amongst staff and creating lasting change. Methods: 1. We adopted multidisciplinary team involvement to support Doctors. MDT staff e.g. Nurses, Physiotherapists, Occupational Therapists and Dieticians, were actively encouraged to fill in the CGA document. 2. We added a CGA Document Pro-forma to “Sunrise EPR” (Trust computer system). These CGAs were to automatically be included the discharge summary. 3. Prior to assessing uptake, we used a spot audit questionnaire to assess staff awareness/knowledge of what a CGA was. 4. We designed and placed posters highlighting domains of CGA and MDT roles suited to each domain on geriatric “Health and Ageing Wards” (HAU) in the hospital. 5. We performed an audit of % discharge summaries which include CGA and MDT role input. 6. We nominated ward champions on each ward from each multidisciplinary specialty to monitor and encourage colleagues to actively complete CGAs. 7. We initiated further education of ward staff on CGA's importance by discussion at board rounds and weekly multidisciplinary meetings. Outcomes: 1. The majority of respondents to our spot audit were aware of what a CGA was, but fewer had used the EPR document to complete one. 2. We found that CGAs were not being commenced for nearly 50% of patients discharged on HAU wards and the Frailty Assessment Unit.

Keywords: comprehensive geriatric assessment, CGA, multidisciplinary team, quality of life, mortality

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900 Intercultural Strategies of Chinese Composers in the Organizational Structure of Their Works

Authors: Bingqing Chen

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The Opium War unlocked the gate of China. Since then, modern western culture has been imported strongly and spread throughout this Asian country. The monologue of traditional Chinese culture in the past has been replaced by the hustle and bustle of multiculturalism. In the field of music, starting from school music, China, a country without the concept of composition, was deeply influenced by western culture and professional music composition, and entered the era of professional music composition. Recognizing the importance of national culture, a group of insightful artists began to try to add ‘China’ to musical composition. However, due to the special historical origin of Chinese professional musical composition and the three times of cultural nihilism in China, professional musical composition at this time failed to interpret the deep language structure of local culture within Chinese traditional culture, but only regarded Chinese traditional music as a ‘melody material library.’ At this time, the cross-cultural composition still takes Western music as its ‘norm,’ while our own music culture only exists as the sound of the contrast of Western music. However, after reading scores extensively, watching video performances, and interviewing several active composers, we found that at least in the past 30 years, China has created some works that can be called intercultural music. In these kinds of music, composers put Chinese and Western, traditional and modern in an almost equal position to have a dialogue based on their deep understanding and respect for the two cultures. This kind of music connects two music worlds, and links the two cultural and ideological worlds behind it, and communicates and grows together. This paper chose the works of three composers with different educational backgrounds, and pay attention to how composers can make a dialogue at the organizational structure level of their works. Based on the strategies adopted by composers in structuring their works, this paper expounds on how the composer's music procedure shows intercultural in terms of whole sound effects and cultural symbols. By actively participating in this intercultural practice, composers resorting to various musical and extra-musical procedures to arrive at the so-called ‘innovation within tradition.’ Through the dialogue, we can activate the space of creative thinking and explore the potential contained in culture. This interdisciplinary research promotes the rethinking of the possibility of innovation in contemporary Chinese intercultural music composition, spanning the fields of sound studies, dialogue theory, cultural research, music theory, and so on. Recently, China is calling for actively promoting 'the construction of Chinese music canonization,’ expecting to form a particular music style to show national-cultural identity. In the era of globalization, it is possible to form a brand-new Chinese music style through intercultural composition, but it is a question about talents, and the key lies in how composers do it. There is no recipe for the formation of the Chinese music style, only the composers constantly trying and tries to solve problems in their works.

Keywords: dialogism, intercultural music, national-cultural identity, organization/structure, sound

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899 Sympatric Calanus Species: A High Temporal Resolution of Reproductive Timing and Stage Composition

Authors: Mads Schultz, Galice Hoarau, Marvin Choquet

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Members of the genus Calanus are key species in the North Atlantic and Arctic marine ecosystems due to their vast abundance and their ability to accumulate high amounts of lipid. As a link between primary producers and higher trophic levels, the temporal presence of each Calanus species is important in a time of changing communities and northward distribution shifts. This study focused on the temporal niches of the sympatric species Calanus helgolandicus, Calanus finmarchicus, Calanus glacialis, and Calanus hyperboreus in Skjerstad fjord, a Norwegian fjord (67˚14’N, 14 ˚44’E). Three depth intervals were sampled monthly over a year, targeting copepodite stages of the genus Calanus. Species determination was carried out genetically using insertion/deletion markers. In addition, during the reproductive season (Jan-May), weekly samples of the upper 50 meters of the water column targeting nauplii and 5 depth intervals targeting copepodites were collected. Nauplii samples were sorted into two groups (NI-NIII and NIV-NVI), and species were genetically identified. Specimens from stage CIV to adults from each depth interval of copepodite sampling were photographed in order to generate a supporting timeline of visual traits, including gonad maturation stage, presence of stomach content, and total lipid content. The most abundant species were Calanus finmarchicus and Calanus glacialis, followed by Calanus hyperboreus. These species were present in the water column throughout the year, whereas Calanus helgolandicus, the least abundant species, was only present during the summer and autumn period. Each species showed distinct temporal niches, with Calanus finmarchicus occupying the upper 50 meters longer than any of the other species. Calanus hyperboreus dominates in abundance early in the spring but are outnumbered by Calanus glacialis and Calanus finmarchicus after spring bloom sets in. In Skjerstad fjord, Calanus hyperboreus is a clear capital breeder with a long period of nauplii presence before the spring bloom. Calanus glacialis and Calanus finmarchicus both utilize income breeding, with Calanus glacialis developing to the larger nauplii stages quicker than Calanus finmarchicus, but also having a shorter reproduction period. Indeed, the “traditional Arctic” species Calanus hyperboreus and Calanus glacialis appear to end their reproduction period earlier than the North Atlantic Calanus finmarchicus.

Keywords: calanus, depth distribution, reproduction, stage composition, temporal niches

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898 Influence of CO₂ on the Curing of Permeable Concrete

Authors: A. M. Merino-Lechuga, A. González-Caro, D. Suescum-Morales, E. Fernández-Ledesma, J. R. Jiménez, J. M. Fernández-Rodriguez

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Since the mid-19th century, the boom in the economy and industry has grown exponentially. This has led to an increase in pollution due to rising Greenhouse Gas (GHG) emissions and the accumulation of waste, leading to an increasingly imminent future scarcity of raw materials and natural resources. Carbon dioxide (CO₂) is one of the primary greenhouse gases, accounting for up to 55% of Greenhouse Gas (GHG) emissions. The manufacturing of construction materials generates approximately 73% of CO₂ emissions, with Portland cement production contributing to 41% of this figure. Hence, there is scientific and social alarm regarding the carbon footprint of construction materials and their influence on climate change. Carbonation of concrete is a natural process whereby CO₂ from the environment penetrates the material, primarily through pores and microcracks. Once inside, carbon dioxide reacts with calcium hydroxide (Ca(OH)2) and/or CSH, yielding calcium carbonates (CaCO3) and silica gel. Consequently, construction materials act as carbon sinks. This research investigated the effect of accelerated carbonation on the physical, mechanical, and chemical properties of two types of non-structural vibrated concrete pavers (conventional and draining) made from natural aggregates and two types of recycled aggregates from construction and demolition waste (CDW). Natural aggregates were replaced by recycled aggregates using a volumetric substitution method, and the CO₂ capture capacity was calculated. Two curing environments were utilized: a carbonation chamber with 5% CO₂ and a standard climatic chamber with atmospheric CO₂ concentration. Additionally, the effect of curing times of 1, 3, 7, 14, and 28 days on concrete properties was analyzed. Accelerated carbonation in-creased the apparent dry density, reduced water-accessible porosity, improved compressive strength, and decreased setting time to achieve greater mechanical strength. The maximum CO₂ capture ratio was achieved with the use of recycled concrete aggregate (52.52 kg/t) in the draining paver. Accelerated carbonation conditions led to a 525% increase in carbon capture compared to curing under atmospheric conditions. Accelerated carbonation of cement-based products containing recycled aggregates from construction and demolition waste is a promising technology for CO₂ capture and utilization, offering a means to mitigate the effects of climate change and promote the new paradigm of circular economy.

Keywords: accelerated carbonation, CO₂ curing, CO₂ uptake and construction and demolition waste., circular economy

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897 Traumatic Brain Injury Induced Lipid Profiling of Lipids in Mice Serum Using UHPLC-Q-TOF-MS

Authors: Seema Dhariwal, Kiran Maan, Ruchi Baghel, Apoorva Sharma, Poonam Rana

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Introduction: Traumatic brain injury (TBI) is defined as the temporary or permanent alteration in brain function and pathology caused by an external mechanical force. It represents the leading cause of mortality and morbidity among children and youth individuals. Various models of TBI in rodents have been developed in the laboratory to mimic the scenario of injury. Blast overpressure injury is common among civilians and military personnel, followed by accidents or explosive devices. In addition to this, the lateral Controlled cortical impact (CCI) model mimics the blunt, penetrating injury. Method: In the present study, we have developed two different mild TBI models using blast and CCI injury. In the blast model, helium gas was used to create an overpressure of 130 kPa (±5) via a shock tube, and CCI injury was induced with an impact depth of 1.5mm to create diffusive and focal injury, respectively. C57BL/6J male mice (10-12 weeks) were divided into three groups: (1) control, (2) Blast treated, (3) CCI treated, and were exposed to different injury models. Serum was collected on Day1 and day7, followed by biphasic extraction using MTBE/Methanol/Water. Prepared samples were separated on Charged Surface Hybrid (CSH) C18 column and acquired on UHPLC-Q-TOF-MS using ESI probe with inhouse optimized parameters and method. MS peak list was generated using Markerview TM. Data were normalized, Pareto-scaled, and log-transformed, followed by multivariate and univariate analysis in metaboanalyst. Result and discussion: Untargeted profiling of lipids generated extensive data features, which were annotated through LIPID MAPS® based on their m/z and were further confirmed based on their fragment pattern by LipidBlast. There is the final annotation of 269 features in the positive and 182 features in the negative mode of ionization. PCA and PLS-DA score plots showed clear segregation of injury groups to controls. Among various lipids in mild blast and CCI, five lipids (Glycerophospholipids {PC 30:2, PE O-33:3, PG 28:3;O3 and PS 36:1 } and fatty acyl { FA 21:3;O2}) were significantly altered in both injury groups at Day 1 and Day 7, and also had VIP score >1. Pathway analysis by Biopan has also shown hampered synthesis of Glycerolipids and Glycerophospholipiods, which coincides with earlier reports. It could be a direct result of alteration in the Acetylcholine signaling pathway in response to TBI. Understanding the role of a specific class of lipid metabolism, regulation and transport could be beneficial to TBI research since it could provide new targets and determine the best therapeutic intervention. This study demonstrates the potential lipid biomarkers which can be used for injury severity diagnosis and identification irrespective of injury type (diffusive or focal).

Keywords: LipidBlast, lipidomic biomarker, LIPID MAPS®, TBI

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896 The Positive Impact of COVID-19 on the Level of Investments of U.S. Retail Investors: Evidence from a Quantitative Online Survey and Ordered Probit Analysis

Authors: Corina E. Niculaescu, Ivan Sangiorgi, Adrian R. Bell

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The COVID-19 pandemic has been life-changing in many aspects of people’s daily and social lives, but has it also changed attitudes towards investments? This paper explores the effect of the COVID-19 pandemic on retail investors’ levels of investments in the U.S. during the first COVID-19 wave in summer 2020. This is an unprecedented health crisis, which could lead to changes in investment behavior, including irrational behavior in retail investors. As such, this study aims to inform policymakers of what happened to investment decisions during the COVID-19 pandemic so that they can protect retail investors during extreme events like a global health crisis. The study aims to answer two research questions. First, was the level of investments affected by the COVID-19 pandemic, and if so, why? Second, how were investments affected by retail investors’ personal experience with COVID-19? The research analysis is based on primary survey data collected on the Amazon Mechanical Turk platform from a representative sample of U.S. respondents. Responses were collected between the 15th of July and 28th of August 2020 from 1,148 U.S. retail investors who hold mutual fund investments and a savings account. The research explores whether being affected by COVID-19, change in the level of savings, and risk capacity can explain the change in the level of investments by using regression analysis. The dependent variable is changed in investments measured as decrease, no change, and increase. For this reason, the methodology used is ordered probit regression models. The results show that retail investors in the U.S. increased their investments during the first wave of COVID-19, which is unexpected as investors are usually more cautious in crisis times. Moreover, the study finds that those who were affected personally by COVID-19 (e.g., tested positive) were more likely to increase their investments, which is irrational behavior and contradicts expectations. An increase in the level of savings and risk capacity was also associated with increased investments. Overall, the findings show that having personal experience with a health crisis can have an impact on one’s investment decisions as well. Those findings are important for both retail investors and policymakers, especially now that online trading platforms have made trading easily accessible to everyone. There are risks and potential irrational behaviors associated with investment decisions during times of crisis, and it is important that retail investors are aware of them before making financial decisions.

Keywords: COVID-19, financial decision-making, health crisis retail investors, survey

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895 Ethiopia as a Tourist Destination: An Exploration of Italian Tourists’ Market Demand

Authors: Frezer Okubay Weldegebriel

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The tourism sector in Ethiopia plays a significant role in the national economy. The government is granting its pledge and readiness to develop this sector through various initiatives since to eradicate poverty and encourage economic development of the country is one of the Millennium Development plans. The tourism sector has been identified as one of the priority economic sectors by many countries, and the Government of Ethiopia has planned to make Ethiopia among the top five African destinations by 2020. Nevertheless, the international tourism demand for Ethiopia currently lags behind other African countries such as South Africa, Egypt, Morocco, Tanzania, and Kenya. Meanwhile, the number of international tourists’ arrival in Ethiopia is recently increasing even if it cannot be competitive with other African countries. Therefore, to offer demand-driven tourism products, the Ethiopian government, Tourism planners, Tour & Travel operators need to understand the important factors, which affect international tourists’ decision to visit Ethiopian destinations. This study was intended to analyze Italian Tourists Demand towards Ethiopian destination. The researcher aimed to identify the demand for Italian tourists’ preference to Ethiopian destinations comparing to the top East African countries. This study uses both qualitative and quantitative research methodology, and the data is manipulating through primary data collection method using questionnaires, interviews, and secondary data by reviewing books, journals, magazines, past researches, and websites. An active and potential Italian tourist cohort, five well-functioning tour operators based in Ethiopia for Italian tourists and professionals from Ethiopian Ministry of Tourism and Culture participated. Based on the analysis of the data collected through the questionnaire, interviews, and reviews of different materials, the study disclosed that the majority of Italian tourists have a high demand on Ethiopian Tourist destination. Historical and cultural interest, safety and security, the hospitality of the people and affordable accommodation coast are the main reason for them. However, some Italian tourists prefer to visit Kenya, Tanzania, and Uganda due to the fact that they are fascinated by adventure, safari and beaches, while Ethiopia cannot provide these attractions. Most Italian tourists have little information and practical experiences on Ethiopian tourism possibilities via a tour and travel companies. Moreover, the insufficient marketing campaign and promotion by Ethiopian Government and Ministry of Tourism could also contribute to the failure of Ethiopian tourism.

Keywords: The demand of Italian tourists, Ethiopia economy, Ethiopia tourism destination, promoting Ethiopia tourism

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894 Influence of Variable Calcium Content on Mechanical Properties of Geopolymer Synthesized at Different Temperature and Moisture Conditions

Authors: Suraj D. Khadka, Priyantha W. Jayawickrama

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In search of a sustainable construction material, geopolymer has been investigated for past decades to evaluate its advantage over conventional products. Synthesis of geopolymer requires a source of aluminosilicate mixed with sodium hydroxide and sodium silicate at different proportions to maintain a Si/Al molar ratio of 1-3 and Na/Al molar ratio of unity. A comprehensive geopolymer study was performed with Metakaolin and Class C Fly ash as primary aluminosilicate sources. Synthesized geopolymer was analyzed for time-dependent viscosity, setting period and strength at varying initial moisture content, curing temperature and humidity. Different concentration of Ca(OH)₂ and CaSO₄.2H₂O were added to vary the amount of calcium contained in synthesized geopolymer. Influence of calcium content in unconfined compressive strength behavior of geopolymer were analyzed. Finally, Scanning Electron Microscopy-Energy Dispersive Spectroscopy (SEM-EDS) was performed to investigate the hardened product. It was observed that fly ash based geopolymer had shortened setting time and faster increase in viscosity as compared to geopolymer synthesized from metakaolin. This was primarily attributed to higher calcium content resulting in formation of calcium silicate hydrates (CSH). SEM-EDS was performed to verify the presence of CSH phases. Spectral analysis of geopolymer prepared by addition of Ca(OH)₂ and CaSO₄.2H₂O indicated higher CSH phases at higher concentration. It was observed that lower concentration of added calcium favored strength gain in geopolymer. However, at higher calcium concentration, decrease in strength was observed. Strength variation was also observed with humidity at initial curing condition. At 100% humidity, geopolymer with added calcium presented higher strength compared to samples cured at ambient humidity condition (40%). Reduction in strength in these samples at lower humidity was primarily attributed to reduction in moisture content in specimen due to the formation of CSH phases and loss of moisture through evaporation. For low calcium content geopolymers, with increase in temperature, gain in strength was observed with maximum strength observed at 200 ˚C. However, samples with higher calcium content demonstrated severe cracking resulting in low strength at elevated temperatures.

Keywords: calcium silicate hydrates, geopolymer, humidity, Scanning Electron Microscopy-Energy Dispersive Spectroscopy, unconfined compressive strength

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893 The Importance of Entrepreneurship for National Economy: Evaluation of Developed and Least Developed Countries

Authors: Adnan Celik

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Entrepreneurs are people who attempt to do a business and do not hesitate to do so. They are involved in the production of economic goods and services through factors of production. They also find the financial resources necessary for production and the markets where the production will be evaluated. After all, they create economic values. The main function of the entrepreneur in contemporary societies is to realize innovations. From this point, the power of the modern entrepreneur is based on her/his capacity to innovate and transform his innovations into tangible commercial products. In this context, the concept of an entrepreneur is used to mean the person or persons who constantly innovate. Successful entrepreneurs take on the role of the locomotive in the development of their countries. They support economic development with their activities. In addition to production and marketing activities, it also has important contributions to employment. Along with the development of the country, they also try to make the income distribution more balanced. Especially developed country entrepreneurs intensely perform the following functions; “to produce new goods and services or to increase the quality and quality of known goods and services; ability to develop and apply new production methods; establishing new organizations in the industry; reach new markets; to find new sources from which raw materials and similar materials can be obtained”. Entrepreneurs who fully implement business functions are easier to achieve economic efficiency. Thus, they provide great advantages to the business and the national economy. Successful entrepreneurs are people who make money by creating economic values. These revenues are; on the one hand, it is distributed to individuals in the business as wages, premiums, or dividends; It is also used in the growth of companies. Thus, employees, managers, entrepreneurs and the whole country can benefit greatly. In the least developed countries, the guiding effect of traditional value patterns on individuals' attitudes and behaviors varies depending on the socio-economic characteristics of individuals. It is normal for an entrepreneur with a low level of education, who was brought up in a traditional structure, to behave in accordance with traditional value patterns. In fact, this is the primary problem of all countries in the development effort. The solution to this problem will be possible by giving the necessary importance to the social dimension as well as the technical dimension of development. This study mainly focuses on the importance of entrepreneurship for the national economy. This issue has been handled separately in terms of developed and least developed countries. As a result of the study, entrepreneurship suggestions were made, especially to least developed countries, with the goal of national economy and development.

Keywords: entrepreneur, entrepreneurship, national economy, entrepreneurship in developed and least developed countries

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892 Transcription Skills and Written Composition in Chinese

Authors: Pui-sze Yeung, Connie Suk-han Ho, David Wai-ock Chan, Kevin Kien-hoa Chung

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Background: Recent findings have shown that transcription skills play a unique and significant role in Chinese word reading and spelling (i.e. word dictation), and written composition development. The interrelationships among component skills of transcription, word reading, word spelling, and written composition in Chinese have rarely been examined in the literature. Is the contribution of component skills of transcription to Chinese written composition mediated by word level skills (i.e., word reading and spelling)? Methods: The participants in the study were 249 Chinese children in Grade 1, Grade 3, and Grade 5 in Hong Kong. They were administered measures of general reasoning ability, orthographic knowledge, stroke sequence knowledge, word spelling, handwriting fluency, word reading, and Chinese narrative writing. Orthographic knowledge- orthographic knowledge was assessed by a task modeled after the lexical decision subtest of the Hong Kong Test of Specific Learning Difficulties in Reading and Writing (HKT-SpLD). Stroke sequence knowledge: The participants’ performance in producing legitimate stroke sequences was measured by a stroke sequence knowledge task. Handwriting fluency- Handwriting fluency was assessed by a task modeled after the Chinese Handwriting Speed Test. Word spelling: The stimuli of the word spelling task consist of fourteen two-character Chinese words. Word reading: The stimuli of the word reading task consist of 120 two-character Chinese words. Written composition: A narrative writing task was used to assess the participants’ text writing skills. Results: Analysis of covariance results showed that there were significant between-grade differences in the performance of word reading, word spelling, handwriting fluency, and written composition. Preliminary hierarchical multiple regression analysis results showed that orthographic knowledge, word spelling, and handwriting fluency were unique predictors of Chinese written composition even after controlling for age, IQ, and word reading. The interaction effects between grade and each of these three skills (orthographic knowledge, word spelling, and handwriting fluency) were not significant. Path analysis results showed that orthographic knowledge contributed to written composition both directly and indirectly through word spelling, while handwriting fluency contributed to written composition directly and indirectly through both word reading and spelling. Stroke sequence knowledge only contributed to written composition indirectly through word spelling. Conclusions: Preliminary hierarchical regression results were consistent with previous findings about the significant role of transcription skills in Chinese word reading, spelling and written composition development. The fact that orthographic knowledge contributed both directly and indirectly to written composition through word reading and spelling may reflect the impact of the script-sound-meaning convergence of Chinese characters on the composing process. The significant contribution of word spelling and handwriting fluency to Chinese written composition across elementary grades highlighted the difficulty in attaining automaticity of transcription skills in Chinese, which limits the working memory resources available for other composing processes.

Keywords: orthographic knowledge, transcription skills, word reading, writing

Procedia PDF Downloads 405
891 Adopting the Community Health Workers Master List Registry for Community Health Workforce in Kenya

Authors: Gikunda Aloise, Mjema Saida, Barasa Herbert, Wanyungu John, Kimani Maureen

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Background: Community Health Workforce (CHW) is health care providers at the community level (Level 1) and serves as a bridge between the community and the formal healthcare system. This human resource has enormous potential to extend healthcare services and ensures that the vulnerable, marginalized, and hard-to-reach populations have access to quality healthcare services at the community and primary health facility levels. However, these cadres are neither recognized, remunerated, nor in most instances, registered in a master list. Management and supervision of CHWs is not easy if their individual demographics, training capacity and incentives is not well documented through a centralized registry. Description: In February 2022, Amref supported the Kenya Ministry of Health in developing a community health workforce database called Community Health Workers Master List Registry (CHWML), which is hosted in Kenya Health Information System (KHIS) tracker. CHW registration exercise was through a sensitization meeting conducted by the County Community Health Focal Person for the Sub-County Community Health Focal Person and Community Health Assistants who uploaded information on individual demographics, training undertaken and incentives received by CHVs. Care was taken to ensure compliance with Kenyan laws on the availability and use of personal data as prescribed by the Data Protection Act, 2019 (DPA). Results and lessons learnt: By June 2022, 80,825 CHWs had been registered in the system; 78,174 (96%) CHVs and 2,636 (4%) CHAs. 25,235 (31%) are male, 55,505 (68%) are female & 85 (1%) are transgender. 39,979. (49%) had secondary education and 2500 (3%) had no formal education. Only 27 641 (34%) received a monthly stipend. 68,436 CHVs (85%) had undergone basic training. However, there is a need to validate the data to align with the current situation in the counties. Conclusions/Next steps: The use of CHWML will unlock opportunities for building more resilient and sustainable health systems and inform financial planning, resource allocation, capacity development, and quality service delivery. The MOH will update the CHWML guidelines in adherence to the data protection act which will inform standard procedures for maintaining, updating the registry and integrate Community Health Workforce registry with the HRH system.

Keywords: community health registry, community health volunteers (CHVs), community health workers masters list (CHWML), data protection act

Procedia PDF Downloads 105
890 The Psychological Effects of Nature on Subjective Well-Being: An Experimental Approach

Authors: Tatjana Kochetkova

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This paper explores the pivotal role of environmental education, specifically outdoor education, in facilitating a psychological connection to nature among young adults. This research aims to contribute to building an empirical and conceptual basis of ecopsychology by providing a picture of psyche-nature interaction. It presents the results of the four-day connection-to-nature workshop. It intends to find out the effects of the awareness of nature on subjective well-being and perception of the meaning of life. This led to finding a battery-recharging effect of nature and the influence of nature at four levels of awareness: external physical perception, internal (bodily) sensation, emotions, and existential meaning. The research on the psychological bond of humans with the natural environment, the subject of ecopsychology, is still in its infancy. However, despite several courageous and fruitful attempts, there are still no direct answers to the fundamental questions about the way in which the natural environment influences humans and the specific role of nature in the human psyche. The urge to address this question was the primary reason for the current experiment. The methodology of this study was taken from the study of Patterson, and from White and Hendee. The methodology included a series of assignments on the perception of nature (the exercises are described in the attachment). Experiences were noted in a personal diary, which we used later for analysis. There are many trustworthy claims that contact with nature has positive effects on human subjective well-being and that it is of essential psychological and spiritual value. But, there is a need for more support and theoretical explanation for this phenomenon. As a contribution to filling these gaps, this qualitative study was conducted. The aim of this study is to explore the psychological effects of short-term awareness of wilderness on one’s subjective well-being and on one’s sense of the meaning of life. This specific study is based on the more general hypothesis that there are positive relationships between the experience of wilderness and the development of the self, feelings of community, and spiritual development. It restricted the study of the psychological effects of short term stay in nature to two variables (subjective well-being and the sense of meaning of life). The study aimed at (i) testing the hypothesis that there are positive effects of the awareness of wilderness on the subjective sense of well-being and meaning in life, (ii) understanding the nature of the psychological need for wilderness. Although there is a substantial amount of data on the psychological benefits of nature, we still lack a theory that explains the findings. The present research aims to contribute to such a theory. This is an experiment aimed specifically at the effects of nature on the sense of well-being and meaning in life.

Keywords: environmental education, psychological connection to nature, subjective well-being, symbolic meaning of nature, emotional reaction to nature, meaning of life

Procedia PDF Downloads 54
889 Resilience of the American Agriculture Sector

Authors: Dipak Subedi, Anil Giri, Christine Whitt, Tia McDonald

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This study aims to understand the impact of the pandemic on the overall economic well-being of the agricultural sector of the United States. The two key metrics used to examine the economic well-being are the bankruptcy rate of the U.S. farm operations and the operating profit margin. One of the primary reasons for farm operations (in the U.S.) to file for bankruptcy is continuous negative profit or a significant decrease in profit. The pandemic caused significant supply and demand shocks in the domestic market. Furthermore, the ongoing trade disruptions, especially with China, also impacted the prices of agricultural commodities. The significantly reduced demand for ethanol and closure of meat processing plants affected both livestock and crop producers. This study uses data from courts to examine the bankruptcy rate over time of U.S. farm operations. Preliminary results suggest there wasn’t an increase in farm operations filing for bankruptcy in 2020. This was most likely because of record high Government payments to producers in 2020. The Federal Government made direct payments of more than $45 billion in 2020. One commonly used economic metric to measure farm profitability is the operating profit margin (OPM). Operating profit margin measures profitability as a share of the total value of production and government payments. The Economic Research Service of the United States Department of Agriculture defines a farm operation to be in a) a high-risk zone if the OPM is less than 10 percent and b) a low-risk zone if the OPM is higher than 25 percent. For this study, OPM was calculated for small, medium, and large-scale farm operations using the data from the Agriculture Resource Management Survey (OPM). Results show that except for small family farms, the share of farms in high-risk zone decreased in 2020 compared to the most recent non-pandemic year, 2019. This was most likely due to higher commodity prices at the end of 2020 and record-high government payments. Further investigation suggests a lower share of smaller farm operations receiving lower average government payments resulting in a large share (over 70 percent) being in the critical zone. This study should be of interest to multiple stakeholders, including policymakers across the globe, as it shows the resilience of the U.S. agricultural system as well as (some) impact of government payments.

Keywords: U.S. farm sector, COVID-19, operating profit margin, farm bankruptcy, ag finance, government payments to the farm sector

Procedia PDF Downloads 71
888 The Effectiveness of a Self-Efficacy Psychoeducational Programme to Enhance Outcomes of Patients with End-Stage Renal Disease

Authors: H. C. Chen, S. W. C. Chan, K. Cheng, A. Vathsala, H. K. Sran, H. He

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Background: End-stage renal disease (ESRD) is the last stage of chronic kidney disease. The numbers of patients with ESRD have increased worldwide due to the growing number of aging, diabetes and hypertension populations. Patients with ESRD suffer from physical illness and psychological distress due to complex treatment regimens, which often affect the patients’ social and psychological functioning. As a result, the patients may fail to perform daily self-care and self-management, and consequently experience worsening conditions. Aims: The study aims to examine the effectiveness of a self-efficacy psychoeducational programme on primary outcome (self-efficacy) and secondary outcomes (psychological wellbeing, treatment adherence, and quality of life) in patients with ESRD and haemodialysis in Singapore. Methodology: A randomised controlled, two-group pretest and repeated posttests design will be carried out. A total of 154 participants (n=154) will be recruited. The participants in the control group will receive a routine treatment. The participants in the intervention group will receive a self-efficacy psychoeducational programme in addition to the routine treatment. The programme is a two-session of educational intervention in a week. A booklet, two consecutive sessions of face-to-face individual education, and an abdominal breathing exercise are adopted in the programme. Outcome measurements include Dialysis Specific Self-efficacy Scale, Kidney Disease Quality of Life- 36 Hospital Anxiety and Depression Scale, Renal Adherence Attitudes Questionnaire and Renal Adherence Behaviour Questionnaire. The questionnaires will be used to measure at baseline, 1- and 3- and 6-month follow-up periods. Process evaluation will be conducted with a semi-structured face to face interview. Quantitative data will be analysed using SPSS21.0 software. Qualitative data will be analysed by content analysis. Significance of the study: This study will identify a clinically useful and potentially effective approach to help patients with end-stage renal disease and haemodialysis by enhancing their self-efficacy in self-care behaviour, and therefore improving their psychological well-being, treatment adherence and quality of life. This study will provide information to develop clinical guidelines to improve patients’ disease self-management and to enhance health-related outcomes and it will help reducing disease burden.

Keywords: end-stage renal disease (ESRD), haemodialysis, psychoeducation, self-efficacy

Procedia PDF Downloads 301
887 Gender Differences in the Impact and Subjective Interpretation of Childhood Sexual Abuse Survivors

Authors: T. Borja-Alvarez, V. Jiménez-Borja, M. Jiménez Borja, C. J. Jiménez-Mosquera

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Research on child sexual abuse has predominantly focused on female survivors. This has resulted in less research looking at the particular context in which this abuse takes place for boys and the impact this abuse may have on male survivors. The aim of this study is to examine the sex and age of the perpetrators of child sexual abuse and explore gender differences in the impact along with the subjective interpretation that survivors attribute to these experiences. The data for this study was obtained from Ecuadorian university students (M = 230, F = 293) who reported sexual abuse using the ISPCAN Child Abuse Screening Tool Retrospective version (ICAST-R). Participants completed Horowitz's Impact of Event Scale (IES) and were also requested to choose among neutral, positive, and negative adjectives to describe these experiences. The results indicate that in the case of males, perpetrators were both males (adults =27%, peers =20%, relatives =10.3%, cousins =7.4%) and young females (girlfriends or ex-girlfriends =25.6%, neighborhood =20.7%, school =16.7%, cousins =15.3%, strangers =12.8%). In contrast, almost all females reported that adult males were the perpetrators (relatives =29.6%, neighborhood =11.9%, strangers =19.9%, family friends =9.7%). Regarding the impact of these events, significant gender differences emerged. More females (50%) than males (20%) presented symptoms of post-traumatic stress disorder (PTSD). Gender differences also surfaced in the way survivors interpret their experiences. Almost half of the male participants selected the word “consensual” followed by the words “normal”, “helped me to mature”, “shameful”, “confusing”, and “traumatic”. In contrast, almost all females chose the word “non-consensual” followed by the words “shameful”, “traumatic”, “scary”, and “confusing”. In conclusion, the findings of this study suggest that young females and adult males were the most common perpetrators of sexually abused boys whereas adult males were the most common perpetrators of sexually abused girls. The impact and the subjective interpretation of these experiences were more negative for girls than for boys. The factors that account for the gender differences in the impact and the interpretation of these experiences need further exploration. It is likely that the cultural expectations of sexual behaviors for boys and girls in Latin American societies may partially explain the differential impact in the way these childhood sexual abuse experiences are interpreted in adulthood. In Ecuador, as is the case in other Latin American countries, the machismo culture not only accepts but encourages early sexual behaviors in boys and negatively judges premature sexual behavior in females. The result of these different sexual expectations may be that sexually abused boys may re-define these experiences as “consensual” and “normal” in adulthood, even though these were not consensual at the time of occurrence. Future studies are needed to more deeply understand the different contexts of sexual abuse for boys and girls in order to analyze the long-term impact of these experiences.

Keywords: abuse, child, gender differences, sexual

Procedia PDF Downloads 82
886 Effectiveness Assessment of a Brazilian Larvicide on Aedes Control

Authors: Josiane N. Muller, Allan K. R. Galardo, Tatiane A. Barbosa, Evan P. Ferro, Wellington M. Dos Santos, Ana Paula S. A. Correa, Edinaldo C. Rego, Jose B. P. Lima

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The susceptibility status of an insect population to any larvicide depends on several factors such includes genetic constitution, environmental conditions and others. The mosquito Aedes aegypti is the primary vector of three important viral diseases, Zika, Dengue, and Chikungunya. The frequent outbreaks of those diseases in different parts of Brazil demonstrate the importance of testing the susceptibility of vectors in different environments. Since the control of this mosquito leads to the control of disease, alternatives for vector control that value the different Brazilian environmental conditions are needed for effective actions. The aim of this study was to evaluate a new commercial formulation of Bacillus thuringiensis israelenses (DengueTech: Brazilian innovative technology) in the Brazilian Legal Amazon considering the climate conditions. Semi-field tests were conducted in the Institute of Scientific and Technological Research of the State of Amapa in two different environments, one in a shaded area and the other exposed to sunlight. The mosquito larvae were exposed to larvicide concentration and a control; each group was tested in three containers of 40 liters each. To assess persistence 50 third instar larvae of Aedes aegypti laboratory lineages (Rockefeller) and 50 larvae of Aedes aegypti collected in the municipality of Macapa, Brazil’s Amapa state, were added weekly and after 24 hours the mortality was assessed. In total 16 tests were performed, where 12 were done with replacement of water (1/5 of the volume, three times per week). The effectiveness of the product was determined through mortality of ≥ 80%, as recommend by the World Health Organization. The results demonstrated that high-water temperatures (26-35 °C) on the containers influenced the residual time of the product, where the maximum effect achieved was 21 days in the shaded area; and no effectiveness of 60 days was found in any of the tests, as expected according to the larvicide company. The test with and without water replacement did not present significant differences in the mortality rate. Considering the different environments and climate, these results stimulate the need to test larvicide and its effectiveness in specific environmental settings in order to identify the parameters required for better results. Thus, we see the importance of semi-field researches considering the local climate conditions for a successful control of Aedes aegypti.

Keywords: Aedes aegypti, bioassay, larvicida, vector control

Procedia PDF Downloads 108
885 The Use of Prestige Language in Tennessee Williams’s "A Streetcar Named Desire"

Authors: Stuart Noel

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In a streetcar Named Desire, Tennessee Williams presents Blanche DuBois, a most complex and intriguing character who often uses prestige language to project the image of an upper-class speaker and to disguise her darker and complicated self. She embodies various fascinating and contrasting characteristics. Like New Orleans (the locale of the play), Blanche represents two opposing images. One image projects that of genteel, Southern charm and beauty, speaking formally and using prestige language and what some linguists refer to as “hypercorrection,” and the other image reveals that of a soiled, deteriorating façade, full of decadence and illusion. Williams said on more than one occasion that Blanche’s use of such language was a direct reflection of her personality and character (as a high school English teacher). Prestige language is an exaggeratedly elevated, pretentious, and oftentimes melodramatic form of one’s language incorporating superstandard or more standard speech than usual in order to project a highly authoritative individual identity. Speech styles carry personal identification meaning not only because they are closely associated with certain social classes but because they tend to be associated with certain conversational contexts. Features which may be considered to be “elaborated” in form (for example, full forms vs. contractions) tend to cluster together in speech registers/styles which are typically considered to be more formal and/or of higher social prestige, such as academic lectures and news broadcasts. Members of higher social classes have access to the elaborated registers which characterize formal writings and pre-planned speech events, such as lectures, while members of lower classes are relegated to using the more economical registers associated with casual, face-to-face conversational interaction, since they do not participate in as many planned speech events as upper-class speakers. Tennessee Williams’s work is characteristically concerned with the conflict between the illusions of an individual and the reality of his/her situation equated with a conflict between truth and beauty. An examination of Blanche DuBois reveals a recurring theme of art and decay and the use of prestige language to reveal artistry in language and to hide a deteriorating self. His graceful and poetic writing personifies her downfall and deterioration. Her loneliness and disappointment are the things so often strongly feared by the sensitive artists and heroes in the world. Hers is also a special and delicate human spirit that is often misunderstood and repressed by society. Blanche is afflicted with a psychic illness growing out of her inability to face the harshness of human existence. She is a sensitive, artistic, and beauty-haunted creature who is avoiding her own humanity while hiding behind her use of prestige language. And she embodies a partial projection of Williams himself.

Keywords: American drama, prestige language, Southern American literature, Tennessee Williams

Procedia PDF Downloads 356
884 Impacts of Public Insurance on Health Access and Outcomes: Evidence from India

Authors: Titir Bhattacharya, Tanika Chakraborty, Prabal K. De

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Maternal and child health continue to be a significant policy focus in developing countries, including India. An emerging model in health care is the creation of public and private partnerships. Since the construction of physical infrastructure is costly, governments at various levels have tried to implement social health insurance schemes where a trust calculates insurance premiums and medical payments. Typically, qualifying families get full subsidization of the premium and get access to private hospitals, in addition to low cost public hospitals, for their tertiary care needs. We analyze one such pioneering social insurance scheme in the Indian state of Andhra Pradesh (AP). The Rajiv Aarogyasri program (RA) was introduced by the Government of AP on a pilot basis in 2007 and implemented in 2008. In this paper, we first examine the extent to which access to reproductive health care changed. For example, the RA scheme reimburses hospital deliveries leading us to expect an increase in institutional deliveries, particularly in private hospitals. Second, we expect an increase in institutional deliveries to also improve child health outcomes. Hence, we estimate if the program improved infant and child mortality. We use District Level Health Survey data to create annual birth cohorts from 2000-2015. Since AP was the only state in which such a state insurance program was implemented, the neighboring states constituted a plausible control group. Combined with the policy timing, and the year of birth, we employ a difference-indifference strategy to identify the effects of RA on the residents of AP. We perform several checks against threats to identification, including testing for pre-treatment trends between the treatment and control states. We find that the policy significantly lowered infant and child mortality in AP. We also find that deliveries in private hospitals increased, and government hospitals decreased, showing a substitution effect of the relative price change. Finally, as expected, out-of-pocket costs declined for the treatment group. However, we do not find any significant effects for usual preventive care such as vaccination, showing that benefits of insurance schemes targeted at the tertiary level may not trickle down to the primary care level.

Keywords: public health insurance, maternal and child health, public-private choice

Procedia PDF Downloads 59
883 Detection of Egg Proteins in Food Matrices (2011-2021)

Authors: Daniela Manila Bianchi, Samantha Lupi, Elisa Barcucci, Sandra Fragassi, Clara Tramuta, Lucia Decastelli

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Introduction: The undeclared allergens detection in food products plays a fundamental role in the safety of the allergic consumer. The protection of allergic consumers is guaranteed, in Europe, by Regulation (EU) No 1169/2011 of the European Parliament, which governs the consumer's right to information and identifies 14 food allergens to be mandatorily indicated on food labels: among these, an egg is included. An egg can be present as an ingredient or as contamination in raw and cooked products. The main allergen egg proteins are ovomucoid, ovalbumin, lysozyme, and ovotransferrin. This study presents the results of a survey conducted in Northern Italy aimed at detecting the presence of undeclared egg proteins in food matrices in the latest ten years (2011-2021). Method: In the period January 2011 - October 2021, a total of 1205 different types of food matrices (ready-to-eat, meats, and meat products, bakery and pastry products, baby foods, food supplements, pasta, fish and fish products, preparations for soups and broths) were delivered to Food Control Laboratory of Istituto Zooprofilattico Sperimentale of Piemonte Liguria and Valle d’Aosta to be analyzed as official samples in the frame of Regional Monitoring Plan of Food Safety or in the contest of food poisoning. The laboratory is ISO 17025 accredited, and since 2019, it has represented the National Reference Centre for the detection in foods of substances causing food allergies or intolerances (CreNaRiA). All samples were stored in the laboratory according to food business operator instructions and analyzed within the expiry date for the detection of undeclared egg proteins. Analyses were performed with RIDASCREEN®FAST Ei/Egg (R-Biopharm ® Italia srl) kit: the method was internally validated and accredited with a Limit of Detection (LOD) equal to 2 ppm (mg/Kg). It is a sandwich enzyme immunoassay for the quantitative analysis of whole egg powder in foods. Results: The results obtained through this study showed that egg proteins were found in 2% (n. 28) of food matrices, including meats and meat products (n. 16), fish and fish products (n. 4), bakery and pastry products (n. 4), pasta (n. 2), preparations for soups and broths (n.1) and ready-to-eat (n. 1). In particular, in 2011 egg proteins were detected in 5% of samples, in 2012 in 4%, in 2013, 2016 and 2018 in 2%, in 2014, 2015 and 2019 in 3%. No egg protein traces were detected in 2017, 2020, and 2021. Discussion: Food allergies occur in the Western World in 2% of adults and up to 8% of children. Allergy to eggs is one of the most common food allergies in the pediatrics context. The percentage of positivity obtained from this study is, however, low. The trend over the ten years has been slightly variable, with comparable data.

Keywords: allergens, food, egg proteins, immunoassay

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882 Stilbenes as Sustainable Antimicrobial Compounds to Control Vitis Vinifera Diseases

Authors: David Taillis, Oussama Becissa, Julien Gabaston, Jean-Michel Merillon, Tristan Richard, Stephanie Cluzet

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Nowadays, there is a strong pressure to reduce the phytosanitary inputs of synthetic chemistry in vineyards. It is, therefore, necessary to find viable alternatives in order to protect the vine against its major diseases. For this purpose, we suggest the use of a plant extract enriched in antimicrobial compounds. Being produced from vine trunks and roots, which are co-products of wine production, the extract produced is part of a circular economy. The antimicrobial molecules present in this plant material are polyphenols and, more particularly, stilbenes, which are derived from a common base, the resveratrol unit, and that are well known vine phytoalexins. The stilbenoids were extracted from trunks and roots (30/70, w/w) by a double extraction with ethyl acetate followed by enrichment by liquid-liquid extraction. The produced extract was characterized by UHPLC-MS, then its antimicrobial activities were tested on Plasmopara viticola and Botrytis cinerea in the laboratory and/or in greenhouse and in vineyard. The major compounds were purified, and their antimicrobial activity was evaluated on B. cinerea. Moreover, after its spraying, the effect of the stilbene extract on the plant defence status was evaluated by analysis of defence gene expression. UHPLC-MS analysis revealed that the extract contains 50% stilbenes with resveratrol, ε-viniferin and r-viniferin as major compounds. The extract showed antimicrobial activities on P. viticola with IC₅₀ and IC₁₀₀ respectively of 90 and 300 mg/L in the laboratory. In addition, it inhibited 40% of downy mildew development in greenhouse. However, probably because of the sensitivity of stilbenes to the environment, such as UV degradation, no activity has been observed in vineyard towards P. viticola development. For B. cinerea, the extract IC50 was 123 mg/L, with resveratrol and ε-viniferin being the most active stilbenes (IC₅₀ of 88 and 142 mg/L, respectively). The analysis of the expression of defence genes revealed that the extract can induce the expression of some defence genes 24, 48, and 72 hours after treatment, meaning that the extract has a defence-stimulating effect at least for the first three days after treatment. In conclusion, we produced a plant extract enriched in stilbenes with antimicrobial properties against two major grapevine pathogenic agents P. viticola and B. cinerea. In addition, we showed that this extract displayed eliciting activity of plant defences. This extract can therefore represent, after formulation development, a viable eco-friendly alternative for vineyard protection. Subsequently, the effect of the stilbenoid extract on primary metabolism will be evaluated by quantitative NMR.

Keywords: antimicrobial, bioprotection, grapevine, Plasmopara viticola, stilbene

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881 Community Re-Integrated Soldiers’ Perceptions of Barriers and Facilitators to A Home-Based Physical Rehabilitation Programme Following Lower-Limb Amputation

Authors: Ashan Wijekoon, Abi Beane, Subashini Jayawardana

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Background: Soldiers' physical rehabilitation and long term health status has been hindered due to limited investment in and access to rehabilitation services. Home-based rehabilitation programmes could offer a potentially feasible alternative to facilitate long-term recovery. Objectives: To explore Sri Lankan soldiers' perceptions of barriers and facilitators to a home-based physical rehabilitation programme.Methods and Materials: We conducted qualitative semi-structured interviews with community re-integrated army veterans who had undergone unilateral lower limb amputation following war related trauma. Veterans were identified from five districts of Sri Lanka, based on a priori knowledge of veteran community settlements (Disabled Category Registry) obtained from Directorate of Rehabilitation, MoD, Sri Lanka. Individuals were stratified for purposive selection. The interview guide was developed from existing methods and adapted for context. Verbatim transcripts of interviews were analyzed for emerging themes using an inductive approach. Following consent, participants met the researcher (AW- a trained physiotherapist fluent in Sinhalese). Results: Twenty-five Interviews were conducted, totaling 7.2 hours of new data (Mean±SD: 0.28±0.11). All participants were male, aged 30-55 years (Mean±SD: 46.1±7.4), and had experienced traumatic amputation as a result of conflict. Twenty-four sub themes were identified. Inadequate space for exercises, absence of equipment and assistance to conduct the exercises at home, alongside absence of community healthcare services were all barriers. Burden of comorbidities, including chronic pain and disability level, were also barriers. Social support systems, including soldier societies, family, and kinship with other amputees, were seen as facilitators to an at-home programme. Motivation for independence was a strong indicator of engagement. Conclusion: Environment, chronic pain, and absence of well-established community health services were key barriers. Family and soldier support was a facilitator. Engagement with community healthcare providers (physiotherapist and primary care physicians) will be essential to the success of an at-home rehabilitation program.

Keywords: physical rehabilitation, home-based, soldiers, disability, lower-limb amputation, qualitative

Procedia PDF Downloads 153
880 Repurposing Dairy Manure Solids as a Non- Polluting Fertilizer and the Effects on Nutrient Recovery in Tomatoes (Solanum Lycopersicum)

Authors: Devon Simpson

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Recycled Manure Solids (RMS), attained via centrifugation from Canadian dairy farms, were synthesized into a non-polluting fertilizer by bonding micronutrients (Fe, Zn, and Mn) to cellulose fibers and then assessed for the effectiveness of nutrient recovery in tomatoes. Manure management technology is critical for improving the sustainability of agroecosystems and has the capacity to offer a truly circular economy. The ability to add value to manure byproducts offers an opportunity for economic benefits while generating tenable solutions to livestock waste. The dairy industry is under increasing pressure from new environmental protections such as government restrictions on manure applications, limitations on herd size as well as increased product demand from a growing population. Current systems use RMS as bedding, so there is a lack of data pertaining to RMS use as a fertilizer. This is because of nutrient distribution, where most nutrients are retained in the liquid effluent of the solid-liquid separation. A literature review on the physical and chemical properties of dairy manure further revealed more data for raw manure than centrifuged solids. This research offers an innovative perspective and a new avenue of exploration in the use of RMS. Manure solids in this study were obtained directly from dairy farms in Salmon Arm and Abbotsford, British Columbia, and underwent physical, chemical, and biological characterizations pre- and post-synthesis processing. Samples were sent to A&L labs Canada for analysis. Once characterized and bonded to micronutrients, the effect of synthesized RMS on nutrient recovery in tomatoes was studied in a greenhouse environment. The agricultural research package ‘agricolae’ for R was used for experimental design and data analysis. The growth trials consisted of a randomized complete block design (RCBD) that allowed for analysis of variance (ANOVA). The primary outcome was to measure nutrient uptake, and this was done using an Inductively Coupled Plasma Mass Spectrometer (IC-PMS) to analyze the micronutrient content of both the tissue and fruit of the tomatoes. It was found that treatments containing bonded dairy manure solids had an increased micronutrient concentration. Treatments with bonded dairy manure solids also saw an increase in yield, and a brix analysis showed higher sugar content than the untreated control and a grower standard.

Keywords: aoecosystems, dairy manure, micronutrient fertilizer, manure management, nutrient recovery, nutrient recycling, recycled manure solids, regenerative agricugrlture, sustainable farming

Procedia PDF Downloads 173
879 Surface Elevation Dynamics Assessment Using Digital Elevation Models, Light Detection and Ranging, GPS and Geospatial Information Science Analysis: Ecosystem Modelling Approach

Authors: Ali K. M. Al-Nasrawi, Uday A. Al-Hamdany, Sarah M. Hamylton, Brian G. Jones, Yasir M. Alyazichi

Abstract:

Surface elevation dynamics have always responded to disturbance regimes. Creating Digital Elevation Models (DEMs) to detect surface dynamics has led to the development of several methods, devices and data clouds. DEMs can provide accurate and quick results with cost efficiency, in comparison to the inherited geomatics survey techniques. Nowadays, remote sensing datasets have become a primary source to create DEMs, including LiDAR point clouds with GIS analytic tools. However, these data need to be tested for error detection and correction. This paper evaluates various DEMs from different data sources over time for Apple Orchard Island, a coastal site in southeastern Australia, in order to detect surface dynamics. Subsequently, 30 chosen locations were examined in the field to test the error of the DEMs surface detection using high resolution global positioning systems (GPSs). Results show significant surface elevation changes on Apple Orchard Island. Accretion occurred on most of the island while surface elevation loss due to erosion is limited to the northern and southern parts. Concurrently, the projected differential correction and validation method aimed to identify errors in the dataset. The resultant DEMs demonstrated a small error ratio (≤ 3%) from the gathered datasets when compared with the fieldwork survey using RTK-GPS. As modern modelling approaches need to become more effective and accurate, applying several tools to create different DEMs on a multi-temporal scale would allow easy predictions in time-cost-frames with more comprehensive coverage and greater accuracy. With a DEM technique for the eco-geomorphic context, such insights about the ecosystem dynamic detection, at such a coastal intertidal system, would be valuable to assess the accuracy of the predicted eco-geomorphic risk for the conservation management sustainability. Demonstrating this framework to evaluate the historical and current anthropogenic and environmental stressors on coastal surface elevation dynamism could be profitably applied worldwide.

Keywords: DEMs, eco-geomorphic-dynamic processes, geospatial Information Science, remote sensing, surface elevation changes,

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878 Implementing the WHO Air Quality Guideline for PM2.5 Worldwide can Prevent Millions of Premature Deaths Per Year

Authors: Despina Giannadaki, Jos Lelieveld, Andrea Pozzer, John Evans

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Outdoor air pollution by fine particles ranks among the top ten global health risk factors that can lead to premature mortality. Epidemiological cohort studies, mainly conducted in United States and Europe, have shown that the long-term exposure to PM2.5 (particles with an aerodynamic diameter less than 2.5μm) is associated with increased mortality from cardiovascular, respiratory diseases and lung cancer. Fine particulates can cause health impacts even at very low concentrations. Previously, no concentration level has been defined below which health damage can be fully prevented. The World Health Organization ambient air quality guidelines suggest an annual mean PM2.5 concentration limit of 10μg/m3. Populations in large parts of the world, especially in East and Southeast Asia, and in the Middle East, are exposed to high levels of fine particulate pollution that by far exceeds the World Health Organization guidelines. The aim of this work is to evaluate the implementation of recent air quality standards for PM2.5 in the EU, the US and other countries worldwide and estimate what measures will be needed to substantially reduce premature mortality. We investigated premature mortality attributed to fine particulate matter (PM2.5) under adults ≥ 30yrs and children < 5yrs, applying a high-resolution global atmospheric chemistry model combined with epidemiological concentration-response functions. The latter are based on the methodology of the Global Burden of Disease for 2010, assuming a ‘safe’ annual mean PM2.5 threshold of 7.3μg/m3. We estimate the global premature mortality by PM2.5 at 3.15 million/year in 2010. China is the leading country with about 1.33 million, followed by India with 575 thousand and Pakistan with 105 thousand. For the European Union (EU) we estimate 173 thousand and the United States (US) 52 thousand in 2010. Based on sensitivity calculations we tested the gains from PM2.5 control by applying the air quality guidelines (AQG) and standards of the World Health Organization (WHO), the EU, the US and other countries. To estimate potential reductions in mortality rates we take into consideration the deaths that cannot be avoided after the implementation of PM2.5 upper limits, due to the contribution of natural sources to total PM2.5 and therefore to mortality (mainly airborne desert dust). The annual mean EU limit of 25μg/m3 would reduce global premature mortality by 18%, while within the EU the effect is negligible, indicating that the standard is largely met and that stricter limits are needed. The new US standard of 12μg/m3 would reduce premature mortality by 46% worldwide, 4% in the US and 20% in the EU. Implementing the AQG by the WHO of 10μg/m3 would reduce global premature mortality by 54%, 76% in China and 59% in India. In the EU and US, the mortality would be reduced by 36% and 14%, respectively. Hence, following the WHO guideline will prevent 1.7 million premature deaths per year. Sensitivity calculations indicate that even small changes at the lower PM2.5 standards can have major impacts on global mortality rates.

Keywords: air quality guidelines, outdoor air pollution, particulate matter, premature mortality

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877 Cultural Heritage Resources for Tourism, Two Countries – Two Approaches: A Comparative Analysis of Cultural Tourism Products in Turkey and Austria

Authors: Irfan Arikan, George Christian Steckenbauer

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Turkey and Austria are examples for highly developed tourism destinations, where tourism providers use cultural heritage and regional natural resources to develop modern tourism products in order to be successful on increasingly competitive international tourism markets. The use and exploitation of these resources follow on the one hand international standards of tourism marketing (as ‘sustainability’). Therefore, we find highly comparable internationalized products in these destinations (like hotel products, museums, spas etc.). On the other hand, development standards and processes strongly depend on local, regional and national cultures, which influence the way how people work, cooperate, think and create. Thus, cultural factors also influence the attitude towards cultural heritage and natural resources and the way, how these resources are used for the creation of tourism products. This leads to differences in the development of tourism products on several levels: 1. In the selection of cultural heritage and natural resources for the product development process 2. In the processes, how tourism products are created 3. In the way, how providers and marketing organisations work with tourism products based on cultural heritage or natural resources. Aim of this paper is to discover differences in these dimensions by analysing and comparing examples of tourism products in Turkey and Austria, both countries with a highly developed, high professional tourism industry and rich experience of stakeholders in tourism industry in the field of product development and marketing. The cases are selected from the following fields: + Cultural tourism / heritage tourism + City tourism + Industrial heritage tourism + Nature and outdoor tourism + Health tourism The cases are analysed based on available secondary data (as several cases are scientifically described) and expert interviews with local and regional stakeholders of tourism industry and tourism experts. The available primary and secondary data will be analysed and displayed in a comparative structure that allows to derive answers to the above stated research question. The result of the project therefore will be a more precise picture about the influence of cultural differences on the use and exploitation of resources in the field of tourism that allows developing recommendations for tourism industry, which must be taken into consideration to assure cultural and natural resources are treated in a sustainable and responsible way. The authors will edit these culture-cross recommendations in form of a ‘check-list’ that can be used as a ‘guideline’ for tourism professionals in the field of product development and marketing and therefore connects theoretical research to the field of practical application and closes the gap between academic research and the field of tourism practice.

Keywords: cultural heritage, natural resources, Austria, Turkey

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876 Endotracheal Intubation Self-Confidence: Report of a Realistic Simulation Training

Authors: Cleto J. Sauer Jr., Rita C. Sauer, Chaider G. Andrade, Doris F. Rabelo

Abstract:

Introduction: Endotracheal Intubation (ETI) is a procedure for clinical management of patients with severe clinical presentation of COVID-19 disease. Realistic simulation (RS) is an active learning methodology utilized for clinical skill's improvement. To improve ETI skills of public health network's physicians from Recôncavo da Bahia region in Brazil, during COVID-19 outbreak, RS training was planned and carried out. Training scenario included the Nasco Lifeform realistic simulator, and three actions were simulated: ETI procedure, sedative drugs management, and bougie guide utilization. Training intervention occurred between May and June 2020, as an interinstitutional cooperation between the Health's Department of Bahia State and the Federal University from Recôncavo da Bahia. Objective: The main objective is to report the effects on participants' self-confidence perception for ETI procedure after RS based training. Methods: This is a descriptive study, with secondary data extracted from questionnaires applied throughout RS training. Priority workplace, time from last intubation, and knowledge about bougie were reported on a preparticipation questionnaire. Additionally, participants completed pre- and post-training qualitative self-assessment (10-point Likert scale) regarding self-confidence perception in performing each of simulated actions. Distribution analysis for qualitative data was performed with Wilcoxon Signed Rank Test, and self-confidence increase analysis in frequency contingency tables with Fisher's Exact Test. Results: 36 physicians participated of training, 25 (69%) from primary care setting, 25 (69%) performed ETI over a year ago, and only 4 (11%) had previous knowledge about the bougie guide utilization. There was an increase in self-confidence medians for all three simulated actions. Medians (variation) for self-confidence before and after training, for each simulated action were as follows: ETI [5 (1-9) vs. 8 (6-10) (p < 0.0001)]; Sedative drug management [5 (1-9) vs. 8 (4-10) (p < 0.0001)]; Bougie guide utilization [2.5 (1-7) vs. 8 (4-10) (p < 0.0001)]. Among those who performed ETI over a year ago (n = 25), an increase in self-confidence greater than 3 points for ETI was reported by 23 vs. 2 physicians (p = 0.0002), and by 21 vs. 4 (p = 0.03) for sedative drugs management. Conclusions: RS training contributed to self-confidence increase in performing ETI. Among participants who performed ETI over a year, there was a significant association between RS training and increase of more than 3 points in self-confidence, both for ETI and sedative drug management. Training with RS methodology is suitable for ETI confidence enhancement during COVID-19 outbreak.

Keywords: confidence, COVID-19, endotracheal intubation, realistic simulation

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