Search results for: wound status analysis
Commenced in January 2007
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Edition: International
Paper Count: 29470

Search results for: wound status analysis

28660 Influence of Maternal Factors on Growth Patterns of Schoolchildren in a Rural Health and Demographic Surveillance Site in South Africa: A Mixed Method Study

Authors: Perpetua Modjadji, Sphiwe Madiba

Abstract:

Background: The growth patterns of children are good nutritional indicators of their nutritional status, health, and socioeconomic level. However, the maternal factors and the belief system of the society affect the growth of children promoting undernutrition. This study determined the influence of maternal factors on growth patterns of schoolchildren in a rural site. Methods: A convergent mixed method study was conducted among 508 schoolchildren and their mothers in Dikgale Health and Demographic Surveillance System Site, South Africa. Multistage sampling was used to select schools (purposive) and learners (random), who were paired with their mothers. Anthropometry was measured and socio-demographic, obstetrical, household information, maternal influence on children’s nutrition, and growth were assessed using an interviewer administered questionnaire (quantitative). The influence of the cultural beliefs and practices of mothers on the nutrition and growth of their children was explored using focus group discussions (qualitative). Narratives of mothers were used to best understand growth patterns of schoolchildren (mixed method). Data were analyzed using STATA 14 (quantitative) and Nvivo 11 (qualitative). Quantitative and qualitative data were merged for integrated mixed method analysis using a joint display analysis. Results: Mean age of children was 10 ± 2 years, ranging from 6 to 15 years. Substantial percentages of thinness (25%), underweight (24%), and stunting (22%) were observed among the children. Mothers had a mean age of 37 ± 7 years, and 75% were overweight or obese. A depressed socio-economic status indicated by a higher rate of unemployment with no income (82.3%), and dependency on social grants (86.8%) was observed. Determinants of poor growth patterns were child’s age and gender, maternal age, height and BMI, access to water supply, and refrigerator use. The narratives of mothers suggested that the children in most of their households were exposed to poverty and the inadequate intake of quality food. Conclusion: Poor growth patterns were observed among schoolchildren while their mothers were overweight or obese. Child’s gender, school grade, maternal body mass index, and access to water were the main determinants. Congruence was observed between most qualitative themes and quantitative constructs. A need for a multi sectoral approach considering an evidence based and feasible nutrition programs for schoolchildren, especially those in rural settings and educating mothers, cannot be over-emphasized.

Keywords: growth patterns, maternal factors, rural context, schoolchildren, South Africa

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28659 Water Infrastructure Asset Management: A Comparative Analysis of Three Urban Water Utilities in South Africa

Authors: Elkington S. Mnguni

Abstract:

Water and sanitation services in South Africa are characterized by both achievements and challenges. After the end of apartheid in 1994 the newly elected government faced the challenge of eradicating backlogs with respect to access to basic services, including water and sanitation. Capital investment made in the development of new water and sanitation infrastructure to provide basic services to previously disadvantaged communities has grown, to a certain extent, at the expense of investment in the operation and maintenance of new and existing infrastructure. Challenges resulting from aging infrastructure and poor plant performance highlight the need for investing in the maintenance, rehabilitation, and replacement of existing infrastructure to optimize the return on investment. Advanced water infrastructure asset management (IAM) is key to achieving adequate levels of service, particularly with regard to reliable and high quality drinking water supply, prevention of urban flooding, efficient use of natural resources and prevention of pollution and associated risks. Against this backdrop, this paper presents an appraisal of water and sanitation IAM systems in South Africa’s three utilities, being metropolitan cities in the Gauteng Province. About a quarter of the national population lives in the three rapidly urbanizing cities of Johannesburg, Ekurhuleni and Tshwane, located in a semi-arid region. A literature review has been done and field visits to some of the utility facilities are being conducted. Semi-structured interviews will be conducted with the three utilities. The following critical factors are being analysed in terms of compliance with the national Water Services IAM Strategy (2011) and other applicable legislation: asset registers; capacity of assets; current and predicted demand; funding availability / budget allocations; plans: operation & maintenance, renewal & replacement, and risk management; no-drop status (non-revenue water levels); blue drop status (water quality); green drop status (effluent quality); and skills availability. Some of the key challenges identified in the literature review include: funding constraints, Skills shortage, and wastewater treatment plants operating beyond their design capacities. These challenges will be verified during field visits and research interviews. Gaps between literature and practice will be identified and relevant recommendations made if necessary. The objective of this study is to contribute to the resolution of the challenges brought about by the backlogs in the operation and maintenance of water and sanitation assets in the country in general, and in the three cities in particular, thus improving the sustainability thereof.

Keywords: asset management, backlogs, levels of service, sustainability, water and sanitation infrastructure

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28658 Comparative Spatial Analysis of a Re-Arranged Hospital Building

Authors: Burak Köken, Hatice D. Arslan, Bilgehan Y. Çakmak

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Analyzing the relation networks between the hospital buildings which have complex structure and distinctive spatial relationships is quite difficult. The hospital buildings which require specialty in spatial relationship solutions during design and self-innovation through the developing technology should survive and keep giving service even after the disasters such as earthquakes. In this study, a hospital building where the load-bearing system was strengthened because of the insufficient earthquake performance and the construction of an additional building was required to meet the increasing need for space was discussed and a comparative spatial evaluation of the hospital building was made with regard to its status before the change and after the change. For this reason, spatial organizations of the building before change and after the change were analyzed by means of Space Syntax method and the effects of the change on space organization parameters were searched by applying an analytical procedure. Using Depthmap UCL software, connectivity, visual mean depth, beta and visual integration analyses were conducted. Based on the data obtained after the analyses, it was seen that the relationships between spaces of the building increased after the change and the building has become more explicit and understandable for the occupants. Furthermore, it was determined according to findings of the analysis that the increase in depth causes difficulty in perceiving the spaces and the changes considering this problem generally ease spatial use.

Keywords: architecture, hospital building, space syntax, strengthening

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28657 Examination of the Reinforcement Forces Generated in Pseudo-Static and Dynamic Status in Retaining Walls

Authors: K. Passbakhsh

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Determination of reinforcement forces is one of the most important and main discussions in designing retaining walls. By determining these forces we refrain from conservative planning. By numerically modeling the reinforced soil retaining walls under dynamic loading reinforcement forces can be calculated. In this study we try to approach the gained forces by pseudo-static method according to FHWA code and gained forces from numerical modeling by finite element method, by selecting seismic horizontal coefficient for different wall height. PLAXIS software was used for numerical analysis. Then the effect of reinforcement stiffness and soil type on reinforcement forces is examined.

Keywords: reinforced soil, PLAXIS, reinforcement forces, retaining walls

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28656 The Impact of Nutritional Education for Peritoneal Dialysis Patients in Mongolia

Authors: Sanchir Erdenebayar, Namuuntsetseg Oyunbaatar

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Objectives: Peritoneal dialysis treatment is one of the important forms of kidney replacement therapy, and it has recently developed instantly in Mongolia for the past five years. Currently, more than 120 patients undergo peritoneal dialysis nationwide. These patients lack nutritional education, which predisposes them to protein deficiency and further impairs their quality of life. However, there is no study which is conducted among those about their dietary in Mongolia. Therefore, integrated nutrition information and educating them about dietary patterns to follow are urgently needed for PD patients. Methods: A cross-sectional study was carried out on 45 patients aged between 18 and 60 years who were undergoing CAPD at the biggest Medvic dialysis center in Ulaanbaatar. The knowledge of nutrition and food intake is assessed by interview based on a validated questionnaire prepared from KDIGO guidelines, semi-FFQ and a 24-hour dietary recall method. In addition, a biochemical blood test that includes total protein, albumin, calcium, phosphorus, potassium, and hemoglobin is used for an assessment of the patient’s current nutritional status. Results: Knowledge of nutritional status for CAPD was great, with 21.4% of patients and 78.65% having poor nutrition knowledge. The rate of mild to moderate malnutrition was 48.8% among research participants. Serum albumin was 38.4 ± 4.7 g/L, and total protein was 67.3±7.5g/l. Patients met 62.5± 26.5% of their daily intake nutritional requirement for calories and 72±40% of their nutritional requirement for protein. All patients’ energy intake was significantly /1328±304kcal/ lower than the energy requirement (2124±378kcal). Only 14.2% met the recommended dietary protein intake recommended to them of greater than 1.2 g/kg. Conclusions: As was established before, nutritional education has a vital positive impact on the health and nutritional status of peritoneal dialysis patients. The results of this study show that nutritional education programs are not enough adequate in peritoneal dialysis patients. There is a crucial priority to establish nutritional educational programs and guidelines for PD patients in Mongolia.

Keywords: renal diet, peritoneal dialysis, nutrition education, CKD diet

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28655 Robustified Asymmetric Logistic Regression Model for Global Fish Stock Assessment

Authors: Osamu Komori, Shinto Eguchi, Hiroshi Okamura, Momoko Ichinokawa

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The long time-series data on population assessments are essential for global ecosystem assessment because the temporal change of biomass in such a database reflects the status of global ecosystem properly. However, the available assessment data usually have limited sample sizes and the ratio of populations with low abundance of biomass (collapsed) to those with high abundance (non-collapsed) is highly imbalanced. To allow for the imbalance and uncertainty involved in the ecological data, we propose a binary regression model with mixed effects for inferring ecosystem status through an asymmetric logistic model. In the estimation equation, we observe that the weights for the non-collapsed populations are relatively reduced, which in turn puts more importance on the small number of observations of collapsed populations. Moreover, we extend the asymmetric logistic regression model using propensity score to allow for the sample biases observed in the labeled and unlabeled datasets. It robustified the estimation procedure and improved the model fitting.

Keywords: double robust estimation, ecological binary data, mixed effect logistic regression model, propensity score

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28654 Relationship between Job Satisfaction, Job Stressors and Long Term Physical Morbidities among University Employees in Pakistan

Authors: Shahzad A. Mughal, Ameer A. P. Ghaloo, Faisal Laghari, Mohsin A. Mirza

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Job satisfaction and level of job stressors among employees of a university are considered as essential factors responsible for institutional success. Job satisfaction is usually believed as a single baseline variable for the evaluation of a university human resource area. The objectives of this study were to assess the level of job satisfaction and influence of job stressors among university teachers and their association with long term physical health of the employees in government sector universities in Pakistan. A cross-sectional study was conducted on university employees including faculty members and administrative staff of three government sector universities in Sindh province of Pakistan who have completed at least ten years of their job. The study period was six months. All the employees were randomly selected. The job satisfaction scale Questionnaire with yes and no options, together with questions regarding demographic factors, job stress or other working factors and physical health issues were administered in questionnaires. These questionnaires were handed out to 100 faculty members of both genders with permanent job and 50 non faculty staff of grade 17 and above with permanent employment status. Students’ T test and one way ANOVA was applied to categorical variables and Pearson’s correlation analysis was performed to evaluate the correlations between study variables. 121 successful responses were obtained (effective respondent rate 80.6%). The average score of overall job satisfaction was 65.6%. Statistical analysis revealed that the job satisfaction and work related stressors had negative impact on overall health status of the employees with resultant less efficacy and mental stress. The positive relation was perceived by employees for organizational support and high income with job satisfaction. Demographic features such as age and female gender were also linked to the level of job satisfaction and health related issues. The total variation among all responses regarding correlation between job satisfaction job stressors and health related issues was 55%. A study was conducted on University employees of government sector Universities in Pakistan, regarding association of job satisfaction and job stressors with long term physical health of the employees. Study revealed a moderate level of job satisfaction among the employees of all universities included in this study. Attitude and personal relations with heads of the departments and institution along with salary packages were considered as biggest job stressors related correlated directly with physical health. Demographic features and gender were associated factors for job satisfaction. Organizational support was the strongest factor for job satisfaction and results pointed out that by improving support level from University may improve the quality of job satisfaction and overall health of employees.

Keywords: job satisfaction, organizational support, physical health, university employees

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28653 Current Status and Prospects of Further Control of Brucellosis in Humans and Domestic Ruminants in Bangladesh

Authors: A. K. M. Anisur Rahman

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Brucellosis is an ancient and one of the world's most widespread zoonotic diseases affecting both, public health and animal production. Its current status in humans and domestic ruminants along with probable means to control further in Bangladesh are described. The true exposure prevalence of brucellosis in cattle, goats, and sheep seems to be low: 0.3% in cattle, 1% in goats and 1.2% in sheep. The true prevalence of brucellosis in humans was also reported to be around 2%. In such a low prevalence scenario both in humans and animals, the positive predictive values of the diagnostic tests were very low. The role Brucella species in the abortion of domestic ruminants is less likely. Still now, no Brucella spp. was isolated from animal and human samples. However, Brucella abortus DNA was detected from seropositive humans, cattle, and buffalo; milk of cow, goats, and gayals and semen of an infected bull. Consuming raw milk and unpasteurized milk products by Bangladeshi people are not common. Close contact with animals, artificial insemination using semen from infected bulls, grazing mixed species of animals together in the field and transboundary animal movement are important factors, which should be considered for the further control of this zoonosis in Bangladesh.

Keywords: brucellosis, control, human, zoonosis

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28652 The Effects of Self-Efficacy on Life Satisfaction

Authors: Gao ya

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This present study aims to find the relationship between self-efficacy and life satisfaction and the effects of self-efficacy on life satisfaction among Chinese people whose age is from 27-32, born between 1990 and 1995. People who were born between 1990 and 1995 are worthy to receive more attention now because the 90s was always received a lot of focus and labeled negatively as soon as they were born. And a large number of researches study people in individualism society more. So we chose the specific population whose age is from 27 to 32 live in a collectivist society. Demographic information was collected, including age, gender, education level, marital status, income level, number of children. We used the general self-efficacy scale(GSC) and the satisfaction with Life Scale(SLS) to collect data. A total of 350 questionnaires were distributed in and collected from mainland China, then 261 valid questionnaires were returned in the end, making a response rate of 74.57 percent. Some statistics techniques were used, like regression, correlation, ANOVA, T-test and general linear model, to measure variables. The findings were that self-efficacy positively related to life satisfaction. And self-efficacy influences life satisfaction significantly. At the same time, the relationship between demographic information and life satisfaction was analyzed.

Keywords: marital status, life satisfaction, number of children, self-efficacy, income level

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28651 Impact of Tourists on HIV (Human Immunodeficiency Virus) Incidence

Authors: Ofosuhene O. Apenteng, Noor Azina Ismail

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Recently tourism is a major foreign exchange earner in the World. In this paper, we propose the mathematical model to study the impact of tourists on the spread of HIV incidences using compartmental differential equation models. Simulation studies of reproduction number are used to demonstrate new insights on the spread of HIV disease. The periodogram analysis of a time series was used to determine the speed at which the disease is spread. The results indicate that with the persistent flow of tourism into a country, the disease status has increased the epidemic rate. The result suggests that the government must put more control on illegal prostitution, unprotected sexual activity as well as to emphasis on prevention policies that include the safe sexual activity through the campaign by the tourism board.

Keywords: HIV/AIDS, mathematical transmission modeling, tourists, stability, simulation

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28650 Effect of Dietarty Diversity on Maternal Dietary Diversity of Anemia of the Mother during Pregnancy and Prenatal Outcomes: Prospective Cohort Study in Rural Central Ethiopia

Authors: Taddese Alemu Zerfu, Melaku Umeta Deressa, Kaleab Baye

Abstract:

Background: Maternal and child under-nutrition is the underlying cause of 3•5 million annual deaths, globally. Anemia during pregnancy is among the leading nutritional disorders with serious short and long term consequences to both the mother and fetus. Objective: Examine the effect of dietary diversity on maternal anemia, nutritional status and key pregnancy outcomes of pregnancy. Methods: A prospective cohort study design, involving a total of 432 eligible pregnant women, in their second antenatal care visit was conducted between August 2014 to March, 2015. The individual dietary diversity status of mothers was used as the exposure variable to select, enroll and follow the mothers. All mothers were enrolled during second antenatal care visit and followed until delivery. Epi-data, SPSS and STATA software are used to enter and analyze the data. Chi-square test, independent 't'-test, and GLM are used to calculate risk, association and differences between key variables at P < 0.05. Results: Study participants did not differ in many of the basic characteristics (p < 0.05). The incidence of maternal anemia increased significantly from 28.6% to 32.1% between baseline and term. Pregnant mothers with inadequate dietary diversity groups had more (56% at baseline and 68% at term) risk of anemia than the comparison (adequate) groups, (RR, 1.56 and 1.68; 95% CI, 1.24 - 1.83 and 1.39 - 2.04). The overall incidence of still birth, low birth weight and pre-term birth was 4.5%, 9.1% and 13.6%, respectively. The variation of these outcomes was significant across study groups (P < 0.05). Conclusion and recommendations: Dietary diversity status of pregnant mothers has significant effect on the incidence of anemia and key pregnancy outcomes in resource limited settings, like rural Ethiopia. Therefore, apart from the ongoing routine IFA supplementation, special emphasis should be given to dietary diversity of mothers to improve related outcomes of pregnancy and maternal health.

Keywords: anemia, birth weight, dietary diversity, pregnancy, pregnancy outcome

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28649 AI-Based Autonomous Plant Health Monitoring and Control System with Visual Health-Scoring Models

Authors: Uvais Qidwai, Amor Moursi, Mohamed Tahar, Malek Hamad, Hamad Alansi

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This paper focuses on the development and implementation of an advanced plant health monitoring system with an AI backbone and IoT sensory network. Our approach involves addressing the critical environmental factors essential for preserving a plant’s well-being, including air temperature, soil moisture, soil temperature, soil conductivity, pH, water levels, and humidity, as well as the presence of essential nutrients like nitrogen, phosphorus, and potassium. Central to our methodology is the utilization of computer vision technology, particularly a night vision camera. The captured data is then compared against a reference database containing different health statuses. This comparative analysis is implemented using an AI deep learning model, which enables us to generate accurate assessments of plant health status. By combining the AI-based decision-making approach, our system aims to provide precise and timely insights into the overall health and well-being of plants, offering a valuable tool for effective plant care and management.

Keywords: deep learning image model, IoT sensing, cloud-based analysis, remote monitoring app, computer vision, fuzzy control

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28648 Narrative Review Evaluating Systematic Reviews Assessing the Effect of Probiotic Interventions on Depressive Symptoms

Authors: Ibrahim Nadeem, Mohammed Rahman, Yasser Ad-Dab’Bagh, Mahmood Akhtar

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Depression is one of the most prevalent mental illnesses and is often associated with various other medical disorders. In this review, we aim to evaluate existing systematic reviews that investigate the use of probiotics as a treatment for depressive symptoms. Five online databases were searched for relevant studies up to December 2017. Systematic reviews that included randomized controlled trials assessing the efficacy of probiotics in the treatment of depressive symptoms were included. Seven systematic reviews met the inclusion criteria. Three of these reviews conducted meta-analyses, out of which, two found probiotics to significantly improve depressive symptoms in the sample population. Two meta-analyses conducted subgroup analysis based on health status, and both found probiotics to significantly decrease depressive symptoms in patients with major depressive disorder, but only one review found it to significantly decrease in healthy patients. Another subgroup analysis was conducted based on age, and found probiotics to produce significant effects on subjects under the age of 60, but close to no effect on patients over the age of 65. Out of the four reviews that conducted qualitative analysis, three reviews concluded that probiotics have the potential to be used as a treatment. Due to the differences in clinical trials, a definitive effect of probiotics on depressive symptoms cannot be concluded. Nonetheless, probiotics seem to produce a significant therapeutic effect for subjects with pre-existing depressive symptoms. Further studies are warranted for definitive conclusions.

Keywords: depression, gut-brain axis, gut microbiota, probiotic, psychobiotic

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28647 MSIpred: A Python 2 Package for the Classification of Tumor Microsatellite Instability from Tumor Mutation Annotation Data Using a Support Vector Machine

Authors: Chen Wang, Chun Liang

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Microsatellite instability (MSI) is characterized by high degree of polymorphism in microsatellite (MS) length due to a deficiency in mismatch repair (MMR) system. MSI is associated with several tumor types and its status can be considered as an important indicator for tumor prognostic. Conventional clinical diagnosis of MSI examines PCR products of a panel of MS markers using electrophoresis (MSI-PCR) which is laborious, time consuming, and less reliable. MSIpred, a python 2 package for automatic classification of MSI was released by this study. It computes important somatic mutation features from files in mutation annotation format (MAF) generated from paired tumor-normal exome sequencing data, subsequently using these to predict tumor MSI status with a support vector machine (SVM) classifier trained by MAF files of 1074 tumors belonging to four types. Evaluation of MSIpred on an independent 358-tumor test set achieved overall accuracy of over 98% and area under receiver operating characteristic (ROC) curve of 0.967. These results indicated that MSIpred is a robust pan-cancer MSI classification tool and can serve as a complementary diagnostic to MSI-PCR in MSI diagnosis.

Keywords: microsatellite instability, pan-cancer classification, somatic mutation, support vector machine

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28646 Study of Multimodal Resources in Interactions Involving Children with Autistic Spectrum Disorders

Authors: Fernanda Miranda da Cruz

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This paper aims to systematize, descriptively and analytically, the relations between language, body and material world explored in a specific empirical context: everyday co-presence interactions between children diagnosed with Autistic Spectrum Disease ASD and various interlocutors. We will work based on 20 hours of an audiovisual corpus in Brazilian Portuguese language. This analysis focuses on 1) the analysis of daily interactions that have the presence/participation of subjects with a diagnosis of ASD based on an embodied interaction perspective; 2) the study of the status and role of gestures, body and material world in the construction and constitution of human interaction and its relation with linguistic-cognitive processes and Autistic Spectrum Disorders; 3) to highlight questions related to the field of videoanalysis, such as: procedures for recording interactions in complex environments (involving many participants, use of objects and body movement); the construction of audiovisual corpora for linguistic-interaction research; the invitation to a visual analytical mentality of human social interactions involving not only the verbal aspects that constitute it, but also the physical space, the body and the material world.

Keywords: autism spectrum disease, multimodality, social interaction, non-verbal interactions

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28645 Impact of Relocation on Cultural Landscape around Reservoir Projects in Sri Lanka: A Case Study on Uma Oya Multipurpose Development Project

Authors: P. L. Madhushi Kavindya

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Sri Lanka is a developing country where hydrology plays an important role in its economic and social growth, followed by irrigation and power generation. Therefore, reservoirs are a principal element of the culture and social status of Sri Lankans. The emergence of a newly built reservoir goes along with a community relocation process which eventually causes alterations in the cultural landscape around it. From the 18th century, the emergence of reservoirs has caused major impacts on the landscape of Sri Lanka. Foremost aspects can be identified as the increased and decreased value of the cultural landscape around a reservoir. Community relocation in regard to reservoir projects is discussed as a key factor in the research. The study further carries out observations and findings of the relocation process of reservoirs in global and local contexts. Consequently, the study discusses the vast study area of ‘cultural landscape’ in brief and its behavior overall. Besides, specific data about reservoir-related cultural landscapes in a worldwide context, along with facts about the evolution, has been discussed. The significance and diversity of the Sri Lankan reservoir-related cultural landscape are explored in the succeeding study. This study will mainly identify the existing constraints and tendencies regarding the relocation process in an overall status. The base for the research has been laid thereafter by broadening the study on alterations which occur in the cultural landscape in relevance to reservoir-related relocation. Uma Oya multipurpose development project is selected as the exemplary study area considering its visible impacts. This analysis will indicate strategies, theories, and methods that can be applied to apprehend the impact of the relocation process on the cultural landscape of reservoirs. The research was carried out by conducting the Uma Oya multipurpose development project case study and by defining its cultural landscape and process of relocation. A suitable theoretical framework is developed in order to assess the set of vulnerable areas of a cultural landscape which are likely to change due to relocation. A questionnaire survey is done in order to assess socio-economic aspects, and a GIS data analysis is conducted to analyze the impact on physical aspects. Findings show that the impacts of the cultural landscape fall under both positive and negative categories. It also shows that the previous condition before resettlement and post stages have significant changes, where the previous condition had more socio-economic benefits for the community. And it also shows a clear alteration pattern of physical environment changes. These specifically developed theories, areas of assessment, and strategies, along with the outcomes, can be used for any location with geographical similarities worldwide.

Keywords: cultural diffusion theory, cultural landscape, physical aspects, relocation, reservoirs, socio-economic aspects

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28644 An Empirical Examination of Ethnic Differences in the Use and Experience of Child Healthcare Services in New Zealand

Authors: Terryann Clark, Kabir Dasgupta, Sonia Lewycka, Gail Pacheco, Alexander Plum

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This paper focused on two main research aims using data from the Growing Up in New Zealand (GUINZ) birth cohort: 1. To examine ethnic differences in life-course trajectories in the use and experience of healthcare services in early childhood years (namely immunisation, dental checks and use of General Practitioners (GPs)) 2. To quantify the contribution of relevant explanatory factors to ethnic differences. Current policy in New Zealand indicates there should be, in terms of associated direct costs, equitable access by ethnicity for healthcare services. However, empirical evidence points to persistent ethnic gaps in several domains. For example, the data highlighted that Māori have the lowest immunisation rates, across a number of time points in early childhood – despite having a higher antenatal intention to immunise relative to NZ European. Further to that, NZ European are much more likely to have their first-choice lead maternity caregiver (LMC) and use child dental services compared to all ethnicities. Method: This research explored the underlying mechanisms behind ethnic differences in the use and experience of child healthcare services. First, a multivariate regression analysis was used to adjust raw ethnic gaps in child health care utilisation by relevant covariates. This included a range of factors, encompassing mobility, socio-economic status, mother and child characteristics, household characteristics and other social aspects. Second, a decomposition analysis was used to assess the proportion of each ethnic gap that can be explained, as well as the main drivers behind the explained component. The analysis for both econometric approaches was repeated for each data time point available, which included antenatal, 9 months, 2 years and 4 years post-birth. Results: The following findings emerged: There is consistent evidence that Asian and Pacific peoples have a higher likelihood of child immunisation relative to NZ Europeans and Māori. This was evident at all time points except one. Pacific peoples had a lower rate relative to NZ European for receiving all first-year immunisations on time. For a number of potential individual and household predictors of healthcare service utilisation, the association is time-variant across early childhood. For example, socio-economic status appears highly relevant for timely immunisations in a child’s first year, but is then insignificant for the 15 month immunisations and those at age 4. Social factors play a key role. This included discouragement or encouragement regarding child immunisation. When broken down by source, discouragement by family has the largest marginal effect, followed by health professionals; whereas for encouragement, medical professionals have the largest positive influence. Perceived ethnically motivated discrimination by a health professional was significant with respect to both reducing the likelihood of achieving first choice LMC, and also satisfaction levels with child’s GP. Some ethnic gaps were largely unexplained, despite the wealth of factors employed as independent variables in our analysis. This included understanding why Pacific mothers are much less likely to achieve their first choice LMC compared to NZ Europeans; and also the ethnic gaps for both Māori and Pacific peoples relative to NZ Europeans concerning dental service use.

Keywords: child health, cohort analysis, ethnic disparities, primary healthcare

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28643 Identifying the Needs for Renewal of Urban Water Infrastructure Systems: Analysis of Material, Age, Types and Areas: Case Study of Linköping in Sweden

Authors: Eman Hegazy, Stefan Anderberg, Joakim Krook

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Urban water infrastructure is crucial for efficient and reliable water supply in growing cities. With the growth of cities, the need for maintenance and renewal of these systems increases but often goes unfulfilled due to a variety of reasons, such as limited funding, political priorities, or lack of public awareness. Neglecting the renewal needs of these systems can lead to frequent malfunctions and reduced quality and reliability of water supply, as well as increased costs and health and environmental hazards. It is important for cities to prioritize investment in water infrastructure and develop long-term plans to address renewal needs. Drawing general conclusions about the rate of renewal of urban water infrastructure systems at an international or national level can be challenging due to the influence of local management decisions. In many countries, the responsibility for water infrastructure management lies with the municipal authorities, who are responsible for making decisions about the allocation of resources for repair, maintenance, and renewal. These decisions can vary widely based on factors such as local finances, political priorities, and public perception of the importance of water infrastructure. As a result, it is difficult to make generalizations about the rate of renewal across different countries or regions. In Sweden, the situation is not different, and the information from Svenskt Vatten indicates that the rate of renewal varies across municipalities and can be insufficient, leading to a buildup of maintenance and renewal needs. This study aims to examine the adequacy of the rate of renewal of urban water infrastructure in Linköping case city in Sweden. Using a case study framework, the study will assess the current status of the urban water system and the need for renewal. The study will also consider the role of factors such as proper identification processes, limited funding, competing for political priorities, and local management decisions in contributing to insufficient renewal. The study investigates the following questions: (1) What is the current status of water and sewerage networks in terms of length, age distribution, and material composition, estimated total water leakage in the network per year, damages, leaks, and outages occur per year, both overall and by district? (2) What are the main causes of these damages, leaks, and interruptions, and how are they related to lack of maintenance and renewal? (3) What is the current status of renewal work for the water and sewerage networks, including the renewal rate and changes over time, recent renewal material composition, and the budget allocation for renewal and emergency repairs? (4) What factors influence the need for renewal and what conditions should be considered in the assessment? The findings of the study provide insights into the challenges facing urban water infrastructure and identify strategies for improving the rate of renewal to ensure a reliable and sustainable water supply.

Keywords: case study, infrastructure, management, renewal need, Sweden

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28642 Melting and Making Zn-Based Alloys and Examine Their Biodegradable and Biocompatible Properties

Authors: Abdulrahman Sumayli

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Natural Zinc has many significant biological functions, including developments and sustainable of bones and wound healing. Metallic zinc has recently been explored as potential biomaterials that have preferable biodegradable, biocompatible, and mechanical properties. Pure metal zinc has a preferable physical and mechanical properties for biodegradable and biocompatible applications such as density and modulus of elasticity. The aim of the research is to make different Zn-based metallic alloys and test them effectively to be used as biocompatible and biodegradable materials in the field biomedical application. Microstructure study of the as-cast alloys will be examined using SEM (scanning electron microscope) followed by X-ray diffraction investigated so as to evaluate phase constitution of the designed alloys. After that, immersion test and electrochemical test will be applied to the designed alloys so as to study bio corrosion behaviour of the proposed alloys. Finally, in vitro cytocompatibility well conducted to study biocompatibility of the made alloys.

Keywords: Zn-based alloys, biodegradable and biocompatible materials, cytotoxicity test, neutron synchrotron imaging

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28641 Intergenerational Class Mobility in Greece: A Cross-Cohort Analysis with Evidence from European Union-Statistics on Income and Living Conditions

Authors: G. Stamatopoulou, M. Symeonaki, C. Michalopoulou

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In this work, we study the intergenerational social mobility in Greece, in order to provide up-to-date evidence on the changes in the mobility patterns throughout the years. An analysis for both men and women aged between 25-64 years old is carried out. Three main research objectives are addressed. First, we aim to examine the relationship between the socio-economic status of parents and their children. Secondly, we investigate the evolution of the mobility patterns between different birth cohorts. Finally, the role of education is explored in shaping the mobility patterns. For the analysis, we draw data on both parental and individuals' social outcomes from different national databases. The social class of origins and destination is measured according to the European Socio-Economic Classification (ESeC), while the respondents' educational attainment is coded into categories based on the International Standard Classification of Education (ISCED). Applying the Markov transition probability theory, and a range of measures and models, this work focuses on the magnitude and the direction of the movements that take place in the Greek labour market, as well as the level of social fluidity. Three-way mobility tables are presented, where the transition probabilities between the classes of destination and origins are calculated for different cohorts. Additionally, a range of absolute and relative mobility rates, as well as distance measures, are presented. The study covers a large time span beginning in 1940 until 1995, shedding light on the effects of the national institutional processes on the social movements of individuals. Given the evidence on the mobility patterns of the most recent birth cohorts, we also investigate the possible effects of the 2008 economic crisis.

Keywords: cohort analysis, education, Greece, intergenerational mobility, social class

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28640 Application of Discrete-Event Simulation in Health Technology Assessment: A Cost-Effectiveness Analysis of Alzheimer’s Disease Treatment Using Real-World Evidence in Thailand

Authors: Khachen Kongpakwattana, Nathorn Chaiyakunapruk

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Background: Decision-analytic models for Alzheimer’s disease (AD) have been advanced to discrete-event simulation (DES), in which individual-level modelling of disease progression across continuous severity spectra and incorporation of key parameters such as treatment persistence into the model become feasible. This study aimed to apply the DES to perform a cost-effectiveness analysis of treatment for AD in Thailand. Methods: A dataset of Thai patients with AD, representing unique demographic and clinical characteristics, was bootstrapped to generate a baseline cohort of patients. Each patient was cloned and assigned to donepezil, galantamine, rivastigmine, memantine or no treatment. Throughout the simulation period, the model randomly assigned each patient to discrete events including hospital visits, treatment discontinuation and death. Correlated changes in cognitive and behavioral status over time were developed using patient-level data. Treatment effects were obtained from the most recent network meta-analysis. Treatment persistence, mortality and predictive equations for functional status, costs (Thai baht (THB) in 2017) and quality-adjusted life year (QALY) were derived from country-specific real-world data. The time horizon was 10 years, with a discount rate of 3% per annum. Cost-effectiveness was evaluated based on the willingness-to-pay (WTP) threshold of 160,000 THB/QALY gained (4,994 US$/QALY gained) in Thailand. Results: Under a societal perspective, only was the prescription of donepezil to AD patients with all disease-severity levels found to be cost-effective. Compared to untreated patients, although the patients receiving donepezil incurred a discounted additional costs of 2,161 THB, they experienced a discounted gain in QALY of 0.021, resulting in an incremental cost-effectiveness ratio (ICER) of 138,524 THB/QALY (4,062 US$/QALY). Besides, providing early treatment with donepezil to mild AD patients further reduced the ICER to 61,652 THB/QALY (1,808 US$/QALY). However, the dominance of donepezil appeared to wane when delayed treatment was given to a subgroup of moderate and severe AD patients [ICER: 284,388 THB/QALY (8,340 US$/QALY)]. Introduction of a treatment stopping rule when the Mini-Mental State Exam (MMSE) score goes below 10 to a mild AD cohort did not deteriorate the cost-effectiveness of donepezil at the current treatment persistence level. On the other hand, none of the AD medications was cost-effective when being considered under a healthcare perspective. Conclusions: The DES greatly enhances real-world representativeness of decision-analytic models for AD. Under a societal perspective, treatment with donepezil improves patient’s quality of life and is considered cost-effective when used to treat AD patients with all disease-severity levels in Thailand. The optimal treatment benefits are observed when donepezil is prescribed since the early course of AD. With healthcare budget constraints in Thailand, the implementation of donepezil coverage may be most likely possible when being considered starting with mild AD patients, along with the stopping rule introduced.

Keywords: Alzheimer's disease, cost-effectiveness analysis, discrete event simulation, health technology assessment

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28639 Conjugated Linoleic Acid Effect on Body Weight and Body Composition in Women: Systematic Review and Meta-Analysis

Authors: Hanady Hamdallah, H. Elyse Ireland, John H. H. Williams

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Conjugated linoleic acid (CLA) is a food supplement that is reported to have multiple beneficial health effects, including being anti-carcinogenic, anti-inflammatory and anti-obesity. Animal studies have shown a significant anti-obesity effect of CLA, but results in humans were inconsistent, where some of the studies found an anti-obesity effect while other studies failed to find any decline in obesity markers after CLA supplementation. This meta-analysis aimed to determine if oral CLA supplementation has been shown to reduce obesity related markers in women. Pub Med, Cochrane Library, and Google Scholar were used to identify the eligible trials using two main searching strategies: the first one was to search eligible trials using keywords 'Conjugated linoleic acid', 'CLA', 'Women', and the second strategy was to extract the eligible trials from previously published systematic reviews and meta-analyses. The eligible trials were placebo control trials where women supplemented with CLA mixture in the form of oral capsules for 6 months or less. Also, these trials provided information about body composition expressed as body weight (BW), body mass index (BMI), total body fat (TBF), percentage body fat (BF %), and/ or lean body mass (LBM). The quality of each included study was assessed using both JADAD scale and an adapted CONSERT checklist. Meta-analysis of 8 eligible trials showed that CLA supplementation was significantly associated with reduced BW (Mean ± SD, 1.2 ± 0.26 kg, p < 0.001), BMI (0.6 ± 0.13kg/m², p < 0.001) and TBF (0.76 ± 0.26 kg, p= 0.003) in women, when supplemented over 6-16 weeks. Subgroup meta-analysis demonstrated a significant reduction in BW (1.29 ± 0.31 kg, p < 0.001), BMI (0.60 ± 0.14 kg/m², p < 0.001) and TBF (0.82 ± 0.28 kg, p= 0.003) in the trials that had recruited overweight-obese women. The second subgroup meta-analysis, that considered the menopausal status of the participants, found that CLA was significantly associated with reduced BW (1.35 ± 0.37 kg, p < 0.001; 1.05 ± 0.36 kg, p= 0.003) and BMI (0.50 ± 0.17 kg/m², p= 0.003; 0.75 ± 0.2 kg/m², p < 0.001) in both pre and post-menopausal age women, respectively. A reduction in TBF (1.09 ± 0.37 kg, p= 0.003) was only significant in post-menopausal women. Interestingly, CLA supplementation was associated with a significant reduction in BW (1.05 ± 0.35 kg, p< 0.003), BMI (0.73 ± 0.2 kg/m², p < 0.001) and TBF (1.07 ± 0.36 kg, p= 0.003) in the trials without lifestyle monitoring or interventions. No significant effect of CLA on LBM was detected in this meta-analysis. This meta-analysis suggests a moderate anti-obesity effect of CLA on BW, BMI and TBF reduction in women, when supplemented over 6-16 weeks, particularly in overweight-obese women and post-menopausal women. However, this finding requires careful interpretation due to several issues in the designs of available CLA supplementation trials. More well-designed trials are required to confirm this meta-analysis results.

Keywords: body composition, body mass index, body weight, conjugated linoleic acid

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28638 Factors Affecting Time Performance in Building Construction Projects

Authors: Ibraheem A. K. Mahameed

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The aim of this study is to identify the risks affecting time performance of building construction projects in the West Bank in Palestine from contractors’ viewpoint. 38 risks that might affect time performance of building construction projects were defined through a detailed literature review. These risks have been classified into 6 groups: project, managerial, consultant, financial, external, and construction items. A questionnaire survey was performed to rank the considered risks in terms of severity and frequency. The analysis of the survey indicated that the top five risks affecting time performance of building construction projects in Palestine are: award project to the lowest price, political situation, poor communication and coordination between construction parties, change orders, and financial status of contractor.

Keywords: delay, time performance, construction, building

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28637 The Importance of Parental Projective Care in Perceived Parenting Effectiveness in African American Upper Middle Class Families

Authors: Susan D. Toliver

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Within the professional research literature on parenting in the United States, there is a paucity of research on parenting within the African American or Black community. Research on parenting focused on African Americans within the upper middle class, who constitute a critical and growing sector within the African American population, is all but non-existent. Research to address this void is needed. Despite the progress that has been made toward eliminating the long-standing racial divides in U.S. society, these divides persist and continue to affect different experiences and opportunity structures for White Americans versus Black Americans, including those in the upper middle class. Achievement of middle and upper middle class status of adult heads of families has generally been seen as the route to greater success and well-being for their children. While higher family class status is positively correlated with these factors, the strength of the relationship between higher social class and success and well-being is weaker for Black American families as compared to White American families. In light of the realities of racial inequality, African American parents, including those who have achieved higher status, have unique concerns for their children. African American parents, on the basis of their own experiences and their sense of the world as being highly racialized, anticipate the kinds of experiences that their children are likely to encounter as they grow and mature from childhood to adulthood and beyond. Racial discrimination and macro and micro racial aggressions are continued sources of concern for these parents. On the basis of in-depth personal interviews with upper middle class African American parents, findings suggest that the parenting goals and strategies of African American parents are influenced by the continuing significance of race as a social divide, including in higher socio-economic strata, in the United States. Black American families' parenting practices differ from those of White American families and are inclusive of the unique factors that threaten the well-being of African American children. Specifically, parenting practices are shaped by parents' fears about the racial experiences that they anticipate that their children will encounter. Parents' perceptions of parental effectiveness are linked to their ability to prepare their children for success in confronting, understanding, and contextualizing racial inequalities and aggressions. Theories of Parental Projective Care are useful in understanding the special considerations and unique parenting goals and behaviors of higher status African Americans.

Keywords: African American parenting, parental projective care, parenting effectiveness, racial socialization, upper middle class parenting

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28636 Effect of Perception on People’s Behavior in Public Space

Authors: Morteza Maleki

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In the present study is that it tried to behave in the environment to be monitored and the respective roles of environment (assumed as a vessel) and human beings (assumed as occupants of this vessel) inevitably create effects which can be expressed as various behaviors on the part of human being. The mutual relationship between man and his environment is exhibited through perceptions, behaviors, subjective images, activities, etc. This study investigates the conceptual dimension in the form of the four components of readability, sense of place, identity, and Tenability (tenability) at the Ahmadabad Axis in Mashhad. The theoretical fundamentals and the data regarding the status quo were presented through the descriptive method and the proposed policies were derived through analyzing the available status quo information. The required data were gathered from library resources and documents related to the studied area as well as from instruments used in field methods such as questionnaires. Upon conducting the necessary investigation, the conceptual dimension within the design area was analyzed. The SWOT table was presented, and the results obtained for improving environmental perception were arranged in the form of policy-making tables and operational projects tables for improving the sense of place, creating imagery, and other investigated components.

Keywords: public space, perception, environment, behavior

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28635 Food Insecurity Assessment, Consumption Pattern and Implications of Integrated Food Security Phase Classification: Evidence from Sudan

Authors: Ahmed A. A. Fadol, Guangji Tong, Wlaa Mohamed

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This paper provides a comprehensive analysis of food insecurity in Sudan, focusing on consumption patterns and their implications, employing the Integrated Food Security Phase Classification (IPC) assessment framework. Years of conflict and economic instability have driven large segments of the population in Sudan into crisis levels of acute food insecurity according to the (IPC). A substantial number of people are estimated to currently face emergency conditions, with an additional sizeable portion categorized under less severe but still extreme hunger levels. In this study, we explore the multifaceted nature of food insecurity in Sudan, considering its historical, political, economic, and social dimensions. An analysis of consumption patterns and trends was conducted, taking into account cultural influences, dietary shifts, and demographic changes. Furthermore, we employ logistic regression and random forest analysis to identify significant independent variables influencing food security status in Sudan. Random forest clearly outperforms logistic regression in terms of area under curve (AUC), accuracy, precision and recall. Forward projections of the IPC for Sudan estimate that 15 million individuals are anticipated to face Crisis level (IPC Phase 3) or worse acute food insecurity conditions between October 2023 and February 2024. Of this, 60% are concentrated in Greater Darfur, Greater Kordofan, and Khartoum State, with Greater Darfur alone representing 29% of this total. These findings emphasize the urgent need for both short-term humanitarian aid and long-term strategies to address Sudan's deepening food insecurity crisis.

Keywords: food insecurity, consumption patterns, logistic regression, random forest analysis

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28634 Coping Heat Stress By Crushed Fennel (Foeniculum Vulgare) Seeds in Broilers: Growth, Redox Balance, and Humoral Immune Response

Authors: Adia Fatima, Naila Chand, Rifat Ullah Khan

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The goal of this study was to determine how fennel seed supplementation affected broiler growth, carcass quality, antioxidant status, and antibody titer in heat-stressed broilers. A total of 720 one-day-old broiler chickens were weighed and assigned to 28-floor pens (25 broiler chickens per pen). The broiler chickens were housed in a thermoneutral (TN) environment and were exposed to heat stress (HS). For 23 hours, the broiler chickens were kept under fluorescent lighting. For 35d, HS broiler chickens were fed a control diet and three levels of fennel seeds powder at rates of 15g/kg (Fen-15), 20 g/kg (Fen-20), and 25 g/kg (Fen-25). Overall feed intake, weight gain, and dressing % were considerably greater (P < 0.05) in Fen-25 and TN, but FCR was significantly reduced (P<0.01) in the same groups. When TN, Fen-20, and Fen-25 were compared to the control, malondialdehyde (MDA), paraoxonase (PON1), and antibody titer against New Castle disease (ND) were considerably (P < 0.05) greater. Further, the linear and quadratic response was for feed intake, weight gain, FCR, MDA, PON1, and ND titer. It was concluded that Fen-20 and Fen-25 increased broiler growth, carcass quality, antioxidant status, and immunological response under HS conditions.

Keywords: heat stress, growth, antioxidant, immunity

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28633 The Importance of Changing the Traditional Mode of Higher Education in Bangladesh: Creating Huge Job Opportunities for Home and Abroad

Authors: M. M. Shahidul Hassan, Omiya Hassan

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Bangladesh has set its goal to reach upper middle-income country status by 2024. To attain this status, the country must satisfy the World Bank requirement of achieving minimum Gross National Income (GNI). Number of youth job seekers in the country is increasing. University graduates are looking for decent jobs. So, the vital issue of this country is to understand how the GNI and jobs can be increased. The objective of this paper is to address these issues and find ways to create more job opportunities for youths at home and abroad which will increase the country’s GNI. The paper studies proportion of different goods Bangladesh exported, and also the percentage of employment in different sectors. The data used here for the purpose of analysis have been collected from the available literature. These data are then plotted and analyzed. Through these studies, it is concluded that growth in sectors like agricultural, ready-made garments (RMG), jute industries and fisheries are declining and the business community is not interested in setting up capital-intensive industries. Under this situation, the country needs to explore other business opportunities for a higher economic growth rate. Knowledge can substitute the physical resource. Since the country consists of the large youth population, higher education will play a key role in economic development. It now needs graduates with higher-order skills with innovative quality. Such dispositions demand changes in a university’s curriculum, teaching and assessment method which will function young generations as active learners and creators. By bringing these changes in higher education, a knowledge-based society can be created. The application of such knowledge and creativity will then become the commodity of Bangladesh which will help to reach its goal as an upper middle-income country.

Keywords: Bangladesh, economic sectors, economic growth, higher education, knowledge-based economy, massifcation of higher education, teaching and learning, universities’ role in society

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28632 Liminality in Early Career Academic Identities: A Life History Approach

Authors: C. Morris, W. Ashall, K. Telling, L. Kadiwal, J. Kirby, S. Mwale

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This paper addresses experiences of liminality in the early career phase of academia. Liminality is understood as a process moving from one state (in this case of being non-academic) to another (of being academic), caught between or moving in and out these modes of being. Drawing on life-history methods, a group of academics jointly reflected on experiences of the early career. Primarily focused on the theme of imposter syndrome at this career stage, the authors identified feelings of non-belonging and lack of fit with the academy, tracing the biographical, political, and affective dimensions of such responses. Uncertainty around status within seemingly impermeable hierarchies and barriers to progression in combination with our intersectional positionings shaped by sexism, racism, ableism, and classism, led to experiences of liminality, having not yet fully achieved the desired and potentially illusionary status of established academic. Findings are contextualised within the authors’ contrasting disciplinary, departmental, and institutional settings against a backdrop of neoliberalised academia. The paper thereby contributes nuanced understandings of early-career academic identities at a time when this career stage is ever more ill-defined, extended, precarious and uncertain, exposing ongoing impacts of inequities in the contemporary academic milieu.

Keywords: early career, identities, intersectionality, liminality

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28631 Heavy Metal Contamination in Soils: Detection and Assessment Using Machine Learning Algorithms Based on Hyperspectral Images

Authors: Reem El Chakik

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The levels of heavy metals in agricultural lands in Lebanon have been witnessing a noticeable increase in the past few years, due to increased anthropogenic pollution sources. Heavy metals pose a serious threat to the environment for being non-biodegradable and persistent, accumulating thus to dangerous levels in the soil. Besides the traditional laboratory and chemical analysis methods, Hyperspectral Imaging (HSI) has proven its efficiency in the rapid detection of HMs contamination. In Lebanon, a continuous environmental monitoring, including the monitoring of levels of HMs in agricultural soils, is lacking. This is due in part to the high cost of analysis. Hence, this proposed research aims at defining the current national status of HMs contamination in agricultural soil, and to evaluate the effectiveness of using HSI in the detection of HM in contaminated agricultural fields. To achieve the two main objectives of this study, soil samples were collected from different areas throughout the country and were analyzed for HMs using Atomic Absorption Spectrophotometry (AAS). The results were compared to those obtained from the HSI technique that was applied using Hyspex SWIR-384 camera. The results showed that the Lebanese agricultural soils contain high contamination levels of Zn, and that the more clayey the soil is, the lower reflectance it has.

Keywords: agricultural soils in Lebanon, atomic absorption spectrophotometer, hyperspectral imaging., heavy metals contamination

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