Search results for: global communication
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 8928

Search results for: global communication

468 Learning and Teaching Strategies in Association with EXE Program for Master Course Students of Yerevan Brusov State University of Languages and Social Sciences

Authors: Susanna Asatryan

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The author will introduce a single module related to English teaching methodology for master course students getting specialization “A Foreign Language Teacher of High Schools And Professional Educational Institutions” of Yerevan Brusov State University of Languages and Social Sciences. The overall aim of the presentation is to introduce learning and teaching strategies within EXE Computer program for Mastery student-teachers of the University. The author will display the advantages of the use of this program. The learners interact with the teacher in the classroom as well as they are provided an opportunity for virtual domain to carry out their learning procedures in association with assessment and self-assessment. So they get integrated into blended learning. As this strategy is in its piloting stage, the author has elaborated a single module, embracing 3 main sections: -Teaching English vocabulary at high school, -Teaching English grammar at high school, and -Teaching English pronunciation at high school. The author will present the above mentioned topics with corresponding sections and subsections. The strong point is that preparing this module we have planned to display it on the blended learning landscape. So for this account working with EXE program is highly effective. As it allows the users to operate several tools for self-learning and self-testing/assessment. The author elaborated 3 single EXE files for each topic. Each file starts with the section’s subject-specific description: - Objectives and Pre-knowledge, followed by the theoretical part. The author associated and flavored her observations with appropriate samples of charts, drawings, diagrams, recordings, video-clips, photos, pictures, etc. to make learning process more effective and enjoyable. Before or after the article the author has downloaded a video clip, related to the current topic. EXE offers a wide range of tools to work out or prepare different activities and exercises for the learners: 'Interactive/non-interactive' and 'Textual/non-textual'. So with the use of these tools Multi-Select, Multi-Choice, Cloze, Drop-Down, Case Study, Gap-Filling, Matching and different other types of activities have been elaborated and submitted to the appropriate sections. The learners task is to prepare themselves for the coming module or seminar, related to teaching methodology of English vocabulary, grammar, and pronunciation. The point is that the teacher has an opportunity for face to face communication, as well as to connect with the learners through the Moodle, or as a single EXE file offer it to the learners for their self-study and self-assessment. As for the students’ feedback –EXE environment also makes it available.

Keywords: blended learning, EXE program, learning/teaching strategies, self-study/assessment, virtual domain,

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467 Eco-City Planning and Urban Design in Lagos, Nigeria: Recent Innovations, Trends, Concerns, Challenges, and Solutions

Authors: Dahunsi Michael Oluseyi

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This paper aims to extensively examine eco-city planning and urban design in Lagos, Nigeria. It will delve into the city's developments, challenges, and potential solutions to offer insights for sustainable urban growth within the rapidly expanding urban landscape. The research will scrutinize recent innovations, emerging trends, and practical remedies to promote ecological sustainability within an urban framework. It will encompass a more in-depth review of current literature, case studies, and qualitative analyses, thereby augmenting the depth and breadth of the research. The objectives are to assess the current eco-city planning initiatives and urban design trends in Lagos, Nigeria, considering the city's unique characteristics and challenges. To identify and analyze the challenges encountered during the implementation of eco-friendly urban developments in Lagos, to explore and evaluate the innovative and practical solutions that are implemented to promote sustainability within the city, to provide comprehensive insights and actionable recommendations for policymakers, urban planners, and other stakeholders involved in sustainable urban development in Lagos, the rapid urbanization of Lagos has brought forth a myriad of challenges, including a burgeoning population, inadequate infrastructure, waste management issues, and environmental pollution. Eco-city planning has emerged as a promising approach to addressing these obstacles, striving to create urban spaces that are more habitable, resource-efficient, and environmentally friendly. This research holds substantial importance in exploring the application of eco-city planning principles within a megacity like Lagos. Analyzing recent innovations, trends, concerns, challenges, and solutions provides invaluable insights for policymakers, urban planners, and stakeholders dedicated to fostering sustainable urban development. The methodologies employed in this research are structured to embrace a multifaceted and intricate approach, aiming to facilitate a comprehensive understanding of the complexities inherent in eco-city planning and urban design in Lagos, Nigeria. This methodological framework is designed to encompass various diverse strategies and analytical tools to effectively capture the multidimensional aspects of sustainable urban development. It involves an in-depth analysis of academic publications, governmental reports, and urban planning documents to highlight global eco-city planning trends and gather Lagos-specific insights through a detailed exploration of eco-friendly initiatives and projects in Lagos to evaluate successes, challenges, and strategies for addressing environmental concerns by engaging key stakeholders, including urban planners, policymakers, environmental experts, and residents, to collect firsthand perspectives, concerns, and insights. Also, a thorough analysis will be carried out on data collected from literature reviews, case studies, interviews, and surveys used to extract prevalent patterns, challenges, and innovative solutions from diverse sources. This study aims to contribute to the discourse on sustainable urban development by offering a comprehensive analysis of eco-city planning in Lagos and providing practical recommendations for a more sustainable urban future.

Keywords: eco-friendly, innovation, sustainability, stakeholders

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466 Care Experience of a Female Breast Cancer Patient Undergoing Modified Radical Mastectomy

Authors: Ting-I Lin

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Purpose: This article explores the care experience of a 34-year-old female breast cancer patient who was admitted to the intensive care unit after undergoing a modified radical mastectomy. The patient discovered a lump in her right breast during a self-examination and, after mammography and ultrasound-guided biopsy, was diagnosed with a malignant tumor in the right breast. The tumor measured 1.5 x 1.4 x 2 cm, and the patient underwent a modified radical mastectomy. Postoperatively, she exhibited feelings of inferiority due to changes in her appearance. Method: During the care period, we engaged in conversations, observations, and active listening, using Gordon's Eleven Functional Health Patterns for a comprehensive assessment. In collaboration with the critical care team, a psychologist, and an oncology case manager, we conducted an interdisciplinary discussion and reached a consensus on key nursing issues. These included pain related to postoperative tumor excision and disturbed body image due to changes in appearance after surgery. Result: During the care period, a private space was provided to encourage the patient to express her feelings about her altered body image. Communication was conducted through active listening and a non-judgmental approach. The patient's anxiety level, as measured by the depression and anxiety scale, decreased from moderate to mild, and she was able to sleep for 6-8 hours at night. The oncology case manager was invited to provide education on breast reconstruction using breast models and videos to both the patient and her husband. This helped rebuild the patient's confidence. With the patient's consent, a support group was arranged where a peer with a similar experience shared her journey, offering emotional support and encouragement. This helped alleviate the psychological stress and shock caused by the cancer diagnosis. Additionally, pain management was achieved through adjusting the dosage of analgesics, administering Ultracet 37.5 mg/325 mg 1# Q6H PO, along with distraction techniques and acupressure therapy. These interventions helped the patient relax and alleviate discomfort, maintaining her pain score at a manageable level of 3, indicating mild pain. Conclusion: Disturbance in body image can cause significant psychological stress for patients. Through support group discussions, encouraging patients to express their feelings, and providing appropriate education on breast reconstruction and dressing techniques, the patient's self-concept was positively reinforced, and her emotions were stabilized. This led to renewed self-worth and confidence.

Keywords: breast cancer, modified radical mastectomy, acupressure therapy, Gordon's 11 functional health patterns

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465 An Artificially Intelligent Teaching-Agent to Enhance Learning Interactions in Virtual Settings

Authors: Abdulwakeel B. Raji

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This paper introduces a concept of an intelligent virtual learning environment that involves communication between learners and an artificially intelligent teaching agent in an attempt to replicate classroom learning interactions. The benefits of this technology over current e-learning practices is that it creates a virtual classroom where real time adaptive learning interactions are made possible. This is a move away from the static learning practices currently being adopted by e-learning systems. Over the years, artificial intelligence has been applied to various fields, including and not limited to medicine, military applications, psychology, marketing etc. The purpose of e-learning applications is to ensure users are able to learn outside of the classroom, but a major limitation has been the inability to fully replicate classroom interactions between teacher and students. This study used comparative surveys to gain information and understanding of the current learning practices in Nigerian universities and how they compare to these practices compare to the use of a developed e-learning system. The study was conducted by attending several lectures and noting the interactions between lecturers and tutors and as an aftermath, a software has been developed that deploys the use of an artificial intelligent teaching-agent alongside an e-learning system to enhance user learning experience and attempt to create the similar learning interactions to those found in classroom and lecture hall settings. Dialogflow has been used to implement a teaching-agent, which has been developed using JSON, which serves as a virtual teacher. Course content has been created using HTML, CSS, PHP and JAVASCRIPT as a web-based application. This technology can run on handheld devices and Google based home technologies to give learners an access to the teaching agent at any time. This technology also implements the use of definite clause grammars and natural language processing to match user inputs and requests with defined rules to replicate learning interactions. This technology developed covers familiar classroom scenarios such as answering users’ questions, asking ‘do you understand’ at regular intervals and answering subsequent requests, taking advanced user queries to give feedbacks at other periods. This software technology uses deep learning techniques to learn user interactions and patterns to subsequently enhance user learning experience. A system testing has been undergone by undergraduate students in the UK and Nigeria on the course ‘Introduction to Database Development’. Test results and feedback from users shows that this study and developed software is a significant improvement on existing e-learning systems. Further experiments are to be run using the software with different students and more course contents.

Keywords: virtual learning, natural language processing, definite clause grammars, deep learning, artificial intelligence

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464 Increasing System Adequacy Using Integration of Pumped Storage: Renewable Energy to Reduce Thermal Power Generations Towards RE100 Target, Thailand

Authors: Mathuravech Thanaphon, Thephasit Nat

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The Electricity Generating Authority of Thailand (EGAT) is focusing on expanding its pumped storage hydropower (PSH) capacity to increase the reliability of the system during peak demand and allow for greater integration of renewables. To achieve this requirement, Thailand will have to double its current renewable electricity production. To address the challenges of balancing supply and demand in the grid with increasing levels of RE penetration, as well as rising peak demand, EGAT has already been studying the potential for additional PSH capacity for several years to enable an increased share of RE and replace existing fossil fuel-fired generation. In addition, the role that pumped-storage hydropower would play in fulfilling multiple grid functions and renewable integration. The proposed sites for new PSH would help increase the reliability of power generation in Thailand. However, most of the electricity generation will come from RE, chiefly wind and photovoltaic, and significant additional Energy Storage capacity will be needed. In this paper, the impact of integrating the PSH system on the adequacy of renewable rich power generating systems to reduce the thermal power generating units is investigated. The variations of system adequacy indices are analyzed for different PSH-renewables capacities and storage levels. Power Development Plan 2018 rev.1 (PDP2018 rev.1), which is modified by integrating a six-new PSH system and RE planning and development aftermath in 2030, is the very challenge. The system adequacy indices through power generation are obtained using Multi-Objective Genetic Algorithm (MOGA) Optimization. MOGA is a probabilistic heuristic and stochastic algorithm that is able to find the global minima, which have the advantage that the fitness function does not necessarily require the gradient. In this sense, the method is more flexible in solving reliability optimization problems for a composite power system. The optimization with hourly time step takes years of planning horizon much larger than the weekly horizon that usually sets the scheduling studies. The objective function is to be optimized to maximize RE energy generation, minimize energy imbalances, and minimize thermal power generation using MATLAB. The PDP2018 rev.1 was set to be simulated based on its planned capacity stepping into 2030 and 2050. Therefore, the four main scenario analyses are conducted as the target of renewables share: 1) Business-As-Usual (BAU), 2) National Targets (30% RE in 2030), 3) Carbon Neutrality Targets (50% RE in 2050), and 5) 100% RE or full-decarbonization. According to the results, the generating system adequacy is significantly affected by both PSH-RE and Thermal units. When a PSH is integrated, it can provide hourly capacity to the power system as well as better allocate renewable energy generation to reduce thermal generations and improve system reliability. These results show that a significant level of reliability improvement can be obtained by PSH, especially in renewable-rich power systems.

Keywords: pumped storage hydropower, renewable energy integration, system adequacy, power development planning, RE100, multi-objective genetic algorithm

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463 Exploring Communities of Practice through Public Health Walks for Nurse Education

Authors: Jacqueline P. Davies

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Introduction: Student nurses must develop skills in observation, communication and reflection as well as public health knowledge from their first year of training. This paper will explain a method developed for students to collect their own findings about public health in urban areas. These areas are both rich in the history of old public health that informs the content of many traditional public health walks, but are also locations where new public health concerns about chronic disease are concentrated. The learning method explained in this paper enables students to collect their own data and write original work as first year students. Examples of their findings will be given. Methodology: In small groups, health care students are instructed to walk in neighbourhoods near to the hospitals they will soon attend as apprentice nurses. On their walks, they wander slowly, engage in conversations, and enter places open to the public. As they drift, they observe with all five senses in the real three dimensional world to collect data for their reflective accounts of old and new public health. They are encouraged to stop for refreshments and taste, as well as look, hear, smell, and touch while on their walk. They reflect as a group and later develop an individual reflective account in which they write up their deep reflections about what they observed on their walk. In preparation for their walk, they are encouraged to look at studies of quality of Life and other neighbourhood statistics as well as undertaking a risk assessment for their walk. Findings: Reflecting on their walks, students apply theoretical concepts around social determinants of health and health inequalities to develop their understanding of communities in the neighbourhoods visited. They write about the treasured historical architecture made of stone, bronze and marble which have outlived those who built them; but also how the streets are used now. The students develop their observations into thematic analyses such as: what we drink as illustrated by the empty coke can tossed into a now disused drinking fountain; the shift in home-life balance illustrated by streets where families once lived over the shop which are now walked by commuters weaving around each other as they talk on their mobile phones; and security on the street, with CCTV cameras placed at regular intervals, signs warning trespasses and barbed wire; but little evidence of local people watching the street. Conclusion: In evaluations of their first year, students have reported the health walk as one of their best experiences. The innovative approach was commended by the UK governing body of nurse education and it received a quality award from the nurse education funding body. This approach to education allows students to develop skills in the real world and write original work.

Keywords: education, innovation, nursing, urban

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462 Perception of Nurses and Caregivers on Fall Preventive Management for Hospitalized Children Based on Ecological Model

Authors: Mirim Kim, Won-Oak Oh

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Purpose: The purpose of this study was to identify hospitalized children's fall risk factors, fall prevention status and fall prevention strategies recognized by nurses and caregivers of hospitalized children and present an ecological model for fall preventive management in hospitalized children. Method: The participants of this study were 14 nurses working in medical institutions and having more than one year of child care experience and 14 adult caregivers of children under 6 years of age receiving inpatient treatment at a medical institution. One to one interview was attempted to identify their perception of fall preventive management. Transcribed data were analyzed through latent content analysis method. Results: Fall risk factors in hospitalized children were 'unpredictable behavior', 'instability', 'lack of awareness about danger', 'lack of awareness about falls', 'lack of child control ability', 'lack of awareness about the importance of fall prevention', 'lack of sensitivity to children', 'untidy environment around children', 'lack of personalized facilities for children', 'unsafe facility', 'lack of partnership between healthcare provider and caregiver', 'lack of human resources', 'inadequate fall prevention policy', 'lack of promotion about fall prevention', 'a performanceism oriented culture'. Fall preventive management status of hospitalized children were 'absence of fall prevention capability', 'efforts not to fall', 'blocking fall risk situation', 'limit the scope of children's activity when there is no caregiver', 'encourage caregivers' fall prevention activities', 'creating a safe environment surrounding hospitalized children', 'special management for fall high risk children', 'mutual cooperation between healthcare providers and caregivers', 'implementation of fall prevention policy', 'providing guide signs about fall risk'. Fall preventive management strategies of hospitalized children were 'restrain dangerous behavior', 'inspiring awareness about fall', 'providing fall preventive education considering the child's eye level', 'efforts to become an active subject of fall prevention activities', 'providing customed fall prevention education', 'open communication between healthcare providers and caregivers', 'infrastructure and personnel management to create safe hospital environment', 'expansion fall prevention campaign', 'development and application of a valid fall assessment instrument', 'conversion of awareness about safety'. Conclusion: In this study, the ecological model of fall preventive management for hospitalized children reflects various factors that directly or indirectly affect the fall prevention of hospitalized children. Therefore, these results can be considered as useful baseline data for developing systematic fall prevention programs and hospital policies to prevent fall accident in hospitalized children. Funding: This study was funded by the National Research Foundation of South Korea (grant number NRF-2016R1A2B1015455).

Keywords: fall down, safety culture, hospitalized children, risk factors

Procedia PDF Downloads 158
461 Getting It Right Before Implementation: Using Simulation to Optimize Recommendations and Interventions After Adverse Event Review

Authors: Melissa Langevin, Natalie Ward, Colleen Fitzgibbons, Christa Ramsey, Melanie Hogue, Anna Theresa Lobos

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Description: Root Cause Analysis (RCA) is used by health care teams to examine adverse events (AEs) to identify causes which then leads to recommendations for prevention Despite widespread use, RCA has limitations. Best practices have not been established for implementing recommendations or tracking the impact of interventions after AEs. During phase 1 of this study, we used simulation to analyze two fictionalized AEs that occurred in hospitalized paediatric patients to identify and understand how the errors occurred and generated recommendations to mitigate and prevent recurrences. Scenario A involved an error of commission (inpatient drug error), and Scenario B involved detecting an error that already occurred (critical care drug infusion error). Recommendations generated were: improved drug labeling, specialized drug kids, alert signs and clinical checklists. Aim: Use simulation to optimize interventions recommended post critical event analysis prior to implementation in the clinical environment. Methods: Suggested interventions from Phase 1 were designed and tested through scenario simulation in the clinical environment (medicine ward or pediatric intensive care unit). Each scenario was simulated 8 times. Recommendations were tested using different, voluntary teams and each scenario was debriefed to understand why the error was repeated despite interventions and how interventions could be improved. Interventions were modified with subsequent simulations until recommendations were felt to have an optimal effect and data saturation was achieved. Along with concrete suggestions for design and process change, qualitative data pertaining to employee communication and hospital standard work was collected and analyzed. Results: Each scenario had a total of three interventions to test. In, scenario 1, the error was reproduced in the initial two iterations and mitigated following key intervention changes. In scenario 2, the error was identified immediately in all cases where the intervention checklist was utilized properly. Independently of intervention changes and improvements, the simulation was beneficial to identify which of these should be prioritized for implementation and highlighted that even the potential solutions most frequently suggested by participants did not always translate into error prevention in the clinical environment. Conclusion: We conclude that interventions that help to change process (epinephrine kit or mandatory checklist) were more successful at preventing errors than passive interventions (signage, change in memory aids). Given that even the most successful interventions needed modifications and subsequent re-testing, simulation is key to optimizing suggested changes. Simulation is a safe, practice changing modality for institutions to use prior to implementing recommendations from RCA following AE reviews.

Keywords: adverse events, patient safety, pediatrics, root cause analysis, simulation

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460 Syrian-Armenian Women Refugees: Crossing Borders between the Past and the Present, Negotiating between the Private and the Public

Authors: Ani Kojoyan

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The Syrian refugee crisis has been a matter of worldwide concern during the recent years. And though refugees’ problems are contextualized in terms of time and space, the refugee crisis still remains a global issue to discuss. Since the start of the conflict, Armenia has welcomed thousands of Syrian refugees too. Taking into consideration Armenia’s current socio-economic and geopolitical situation, the flow of refugees is a challenge both for the country and for refugees themselves. However, these people are not simply refugees from Syria, they are Syrian-Armenian refugees; people whose ancestors were survivals of the Armenian Genocide, perpetrated by the Ottoman Turks in 1915, people whose ancestors became refugees a century ago in Syria and now, ironically, a century later they follow their ancestors’ paths, turning into refugees themselves in their historical homeland, facing various difficulties, among them socio-economic, socio-ideological, and identity and gender issues, the latter being the main topic of discussion in the present paper. The situation presented above makes us discuss certain questions within this study: how do Syrian-Armenian refugees define themselves and their status? Which are their gender roles in the socio-economic context? How do social and economic challenges re-shape Syrian-Armenian women refugees’ identities? The study applies qualitative research methods of analysis, which includes semi-structured and in-depth interviews with 15 participants (18-25, 26-40 age groups), and two focus group works, involving 8 participants (18-35 age group) for each focus group activity. The activities were carried out in October 2016, Yerevan, Armenia. The study also includes Secondary Data Analysis. In addition, in order to centralize refugee women’s experiences and identity issues, the study adopts a qualitative lens from a feminist standpoint position. It is based on the assumption that human activity structures and limits understanding, and that the distorted comprehension of events or activities has emerged from the male-oriented dominant judgement which can be discovered through uncovering the understanding of the situation from women’s activity perspectives. The findings suggest that identity is dynamic, complex, over-changing and sensitive to time and space, gender and class. The process of re-shaping identity is even more complicated and multi-layered and is based on internal and external factors, conditioned by individual and collective needs and interests. Refugees are mostly considered as people who lost their identity in the past since they have no longer connection anywhere and try to find it in the present. In turn, female refugees, being a more vulnerable class, go through more complicated identity re-formulating discourse negotiations. They stand between the borders of the old and new, borders of lost and re-found selves, borders of creating and self-fashioning, between illusions and the challenging reality. Particularly, refugee women become more sensitive within the discourses of the private and the public domains: some of them try to create a ‘new-self’, creating their space in a new society, whereas others try to negotiate their affective/emotional labour within their own family domains.

Keywords: feminist standpoint position, gender, identity, refugee studies, Syrian-Armenian women refugees

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459 Open Space Use in University Campuses with User Requirements Analysis: The Case of Eskişehir Osmangazi University Meşelik Campus

Authors: Aysen Celen Ozturk, Hatice Dulger

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University may be defined as a teaching institution consisting of faculties, institutes, colleges, and units that have undergraduate and graduate education, scientific research and publications. It has scientific autonomy and public legal personality. Today, universities are not only the institutions in which students and lecturers experience education, training and scientific work. They also offer social, cultural and artistic activities that strengthen the link with the city. This also incorporates all city users into the campus borders. Thus, universities contribute to social and individual development of the country by providing science, art, socio-cultural development, communication and socialization with people of different cultural and social backgrounds. Moreover, universities provide an active social life, where the young population is the majority. This enables the sense of belonging to the users to develop, to increase the interaction between academicians and students, and to increase the learning / producing community by continuing academic sharing environments outside the classrooms. For this reason, besides academic spaces in university campuses, the users also need closed and open spaces where they can socialize, spend time together and relax. Public open spaces are the most important social spaces that individuals meet, express themselves and share. Individuals belonging to different socio-cultural structures and ethnic groups maintain their social experiences with the physical environment they are in, the outdoors, and their actions and sharing in these spaces. While university campuses are being designed for their individual and social development roles, user needs must be determined correctly and design should be realized in this direction. While considering that requirements may change over time, user satisfaction should be questioned at certain periods and new arrangements should be made in existing applications in the direction of current demands. This study aims to determine the user requirements through the case of Eskişehir Osmangazi University, Meşelik Campus / Turkey. Post Occupancy Evaluation (POE) questionnaire, cognitive mapping and deep interview methods are used in the research process. All these methods show that the students, academicians and other officials in the Meşelik Campus of Eskişehir Osmangazi University find way finding elements insufficient and are in need of efficient landscape design and social spaces. This study is important in terms of determining the needs of the users as a design input. This will help improving the quality of common space in Eskişehir Osmangazi University and in other similar universities.

Keywords: university campuses, public open space, user requirement, post occupancy evaluation

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458 Supplementation of Yeast Cell Wall on Growth Performance in Broiler Reared under High Ambient Temperature

Authors: Muhammad Shahzad Hussain

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Two major problems are facing generally by conventional poultry farming that is disease outbreaks and poor performance, which results due to improper management. To enhance the growth performance and efficiency of feed and reduce disease outbreaks, antibiotic growth promoters (AGPs) which are antibiotics at sub-therapeutic levels, are extensively used in the poultry industry. European Union has banned the use of antibiotics due to their presence in poultry products, development of antibiotic-resistant pathogens, and disturbance of normal gut microbial ecology. These residues cause serious health concerns and produce antibiotic resistance in pathogenic microbes in human beings. These issues strengthen the need for the withdrawal of AGPs from poultry feed. Nowadays, global warming is a major issue, and it is more critical in tropical areas like Pakistan, where heat stress is already a major problem. Heat stress leads to poor production performance, high mortality, immuno-suppression, and concomitant diseases outbreak. The poultry feed industry in Pakistan, like other countries of the world, has been facing shortages and high prices of local as well as imported feed ingredients. Prebiotics are potential replacer for AGP as prebiotics has properties to enhance the production potential and reduce the growth of harmful bacteria as well as stimulate the growth/activity of beneficial bacteria. The most commonly used prebiotics in poultry includes mannan oligosaccharide (MOS). MOS is an essential component of the yeast cell wall (YCW) (Saccharomyces cerevisiae); therefore, the YCW wall possesses prebiotic properties. The use of distillery yeast wall (YCW) has the potential to replace conventional AGPs and to reduce mortality due to heat stress as well as to bind toxins in the feed. The dietary addition of YCW has not only positive effects on production performance in poultry during normal conditions but during stressful conditions. A total of 168-day-old broilers were divided into 6 groups, each of which has 28 birds with 4 replicates (n=7).Yeast cell wall (YCW) supplementation @ 0%, 1%, 1.5%, 2%, 2.5%, 3% from day 0 to 35. Heat stress was exposed from day 21 to 35 at 30±1.1ᵒC with relative humidity 65±5%. Zootechnical parameters like body weight, FCR, Organ development, and histomorphometric parameters were studied. A significant weight gain was observed at group C supplemented @ 1.5% YCW during the fifth week. Significant organ weight gain of Gizzard, spleen, small intestine, and cecum was observed at group C supplemented @ 1.5% YCW. According to morphometric indices Duodenum, Jejunum, and Ileum has significant villus height, while Jejunum and Ileum have also significant villus surface area in the group supplemented with 1.5% YCW. IEL count was only decreased in 1.5% YCW-fed group in jejunum and ileum, not in duodenum, that was less in 2% YCW-supplemented group. Dietary yeast cell wall of saccharomyces cerevisiae partially reduced the effects of high ambient temperature in terms of better growth and modified gut histology and components of mucosal immune response to better withstand heat stress in broilers.

Keywords: antibiotics, AGPs, broilers, MOS, prebiotics, YCW

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457 Operation System for Aluminium-Air Cell: A Strategy to Harvest the Energy from Secondary Aluminium

Authors: Binbin Chen, Dennis Y. C. Leung

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Aluminium (Al) -air cell holds a high volumetric capacity density of 8.05 Ah cm-3, benefit from the trivalence of Al ions. Additional benefits of Al-air cell are low price and environmental friendliness. Furthermore, the Al energy conversion process is characterized of 100% recyclability in theory. Along with a large base of raw material reserve, Al attracts considerable attentions as a promising material to be integrated within the global energy system. However, despite the early successful applications in military services, several problems exist that prevent the Al-air cells from widely civilian use. The most serious issue is the parasitic corrosion of Al when contacts with electrolyte. To overcome this problem, super-pure Al alloyed with various traces of metal elements are used to increase the corrosion resistance. Nevertheless, high-purity Al alloys are costly and require high energy consumption during production process. An alternative approach is to add inexpensive inhibitors directly into the electrolyte. However, such additives would increase the internal ohmic resistance and hamper the cell performance. So far these methods have not provided satisfactory solutions for the problem within Al-air cells. For the operation of alkaline Al-air cell, there are still other minor problems. One of them is the formation of aluminium hydroxide in the electrolyte. This process decreases ionic conductivity of electrolyte. Another one is the carbonation process within the gas diffusion layer of cathode, blocking the porosity of gas diffusion. Both these would hinder the performance of cells. The present work optimizes the above problems by building an Al-air cell operation system, consisting of four components. A top electrolyte tank containing fresh electrolyte is located at a high level, so that it can drive the electrolyte flow by gravity force. A mechanical rechargeable Al-air cell is fabricated with low-cost materials including low grade Al, carbon paper, and PMMA plates. An electrolyte waste tank with elaborate channel is designed to separate the hydrogen generated from the corrosion, which would be collected by gas collection device. In the first section of the research work, we investigated the performance of the mechanical rechargeable Al-air cell with a constant flow rate of electrolyte, to ensure the repeatability experiments. Then the whole system was assembled together and the feasibility of operating was demonstrated. During experiment, pure hydrogen is collected by collection device, which holds potential for various applications. By collecting this by-product, high utilization efficiency of aluminum is achieved. Considering both electricity and hydrogen generated, an overall utilization efficiency of around 90 % or even higher under different working voltages are achieved. Fluidic electrolyte could remove aluminum hydroxide precipitate and solve the electrolyte deterioration problem. This operation system provides a low-cost strategy for harvesting energy from the abundant secondary Al. The system could also be applied into other metal-air cells and is suitable for emergency power supply, power plant and other applications. The low cost feature implies great potential for commercialization. Further optimization, such as scaling up and optimization of fabrication, will help to refine the technology into practical market offerings.

Keywords: aluminium-air cell, high efficiency, hydrogen, mechanical recharge

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456 Documentary Filmmaking as Activism: Case Studies in Advocacy and Social Justice

Authors: Babatunde Kolawole

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This paper embarks on an exploration of the compelling interplay between documentary filmmaking and activism, delving into their symbiotic relationship and profound impact on advocacy and social justice causes. Through an in-depth analysis of diverse case studies, it seeks to illuminate the instances where documentary films have emerged as potent tools for effecting social change and advancing the principles of justice. This research underscores the vital role played by documentary filmmakers in harnessing the medium's unique capacity to engage, educate, and mobilize audiences while advocating for societal transformation. The primary focus of this study is on a selection of compelling case studies spanning various topics and causes, each exemplifying the marriage between documentary filmmaking and activism. These case studies encompass a broad spectrum of subjects, from environmental conservation and climate change to civil rights movements and human rights struggles. By examining these real-world instances, this paper endeavors to provide a comprehensive understanding of the strategies, challenges, and ethical considerations that underpin the practice of documentary filmmaking as a form of activism. Throughout the paper, it becomes evident that the potency of documentary filmmaking lies in its ability to blend artistry with social impact. The selected case studies vividly demonstrate how documentary filmmakers, armed with cameras and a passion for change, have emerged as critical agents of societal transformation. Whether it be exposing environmental atrocities, shedding light on systemic inequalities, or giving voice to marginalized communities, these documentaries have played a pivotal role in pushing the boundaries of advocacy and social justice. One of the key themes explored in this paper is the evolving nature of documentary filmmaking as a tool for activism. It delves into the shift from traditional observational documentaries to more participatory and immersive approaches, highlighting the dynamic ways in which filmmakers engage with their subjects and audiences. This evolution is exemplified in case studies where filmmakers have collaborated with the communities they document, fostering a sense of agency and empowerment among those whose stories are being told. Furthermore, this research underscores the ethical considerations inherent in the intersection of documentary filmmaking and activism. It scrutinizes questions surrounding representation, objectivity, and the responsibility of filmmakers in portraying complex social issues. By dissecting ethical dilemmas faced by documentary filmmakers in these case studies, this paper encourages a critical examination of the ethical boundaries and obligations in the realm of advocacy-driven filmmaking. In conclusion, this paper aims to shed light on the remarkable potential of documentary filmmaking as a catalyst for activism and social justice. Through the lens of compelling case studies, it illustrates the transformative power of the medium in effecting change, amplifying underrepresented voices, and mobilizing global audiences. It is hoped that this research will not only inform the discourse on documentary activism but also inspire filmmakers, scholars, and advocates to continue leveraging the cinematic art form as a formidable force for a more just and equitable world.

Keywords: film, filmmaker, documentary, human right

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455 Recognition by the Voice and Speech Features of the Emotional State of Children by Adults and Automatically

Authors: Elena E. Lyakso, Olga V. Frolova, Yuri N. Matveev, Aleksey S. Grigorev, Alexander S. Nikolaev, Viktor A. Gorodnyi

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The study of the children’s emotional sphere depending on age and psychoneurological state is of great importance for the design of educational programs for children and their social adaptation. Atypical development may be accompanied by violations or specificities of the emotional sphere. To study characteristics of the emotional state reflection in the voice and speech features of children, the perceptual study with the participation of adults and the automatic recognition of speech were conducted. Speech of children with typical development (TD), with Down syndrome (DS), and with autism spectrum disorders (ASD) aged 6-12 years was recorded. To obtain emotional speech in children, model situations were created, including a dialogue between the child and the experimenter containing questions that can cause various emotional states in the child and playing with a standard set of toys. The questions and toys were selected, taking into account the child’s age, developmental characteristics, and speech skills. For the perceptual experiment by adults, test sequences containing speech material of 30 children: TD, DS, and ASD were created. The listeners were 100 adults (age 19.3 ± 2.3 years). The listeners were tasked with determining the children’s emotional state as “comfort – neutral – discomfort” while listening to the test material. Spectrographic analysis of speech signals was conducted. For automatic recognition of the emotional state, 6594 speech files containing speech material of children were prepared. Automatic recognition of three states, “comfort – neutral – discomfort,” was performed using automatically extracted from the set of acoustic features - the Geneva Minimalistic Acoustic Parameter Set (GeMAPS) and the extended Geneva Minimalistic Acoustic Parameter Set (eGeMAPS). The results showed that the emotional state is worse determined by the speech of TD children (comfort – 58% of correct answers, discomfort – 56%). Listeners better recognized discomfort in children with ASD and DS (78% of answers) than comfort (70% and 67%, respectively, for children with DS and ASD). The neutral state is better recognized by the speech of children with ASD (67%) than by the speech of children with DS (52%) and TD children (54%). According to the automatic recognition data using the acoustic feature set GeMAPSv01b, the accuracy of automatic recognition of emotional states for children with ASD is 0.687; children with DS – 0.725; TD children – 0.641. When using the acoustic feature set eGeMAPSv01b, the accuracy of automatic recognition of emotional states for children with ASD is 0.671; children with DS – 0.717; TD children – 0.631. The use of different models showed similar results, with better recognition of emotional states by the speech of children with DS than by the speech of children with ASD. The state of comfort is automatically determined better by the speech of TD children (precision – 0.546) and children with ASD (0.523), discomfort – children with DS (0.504). The data on the specificities of recognition by adults of the children’s emotional state by their speech may be used in recruitment for working with children with atypical development. Automatic recognition data can be used to create alternative communication systems and automatic human-computer interfaces for social-emotional learning. Acknowledgment: This work was financially supported by the Russian Science Foundation (project 18-18-00063).

Keywords: autism spectrum disorders, automatic recognition of speech, child’s emotional speech, Down syndrome, perceptual experiment

Procedia PDF Downloads 186
454 A Semi-supervised Classification Approach for Trend Following Investment Strategy

Authors: Rodrigo Arnaldo Scarpel

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Trend following is a widely accepted investment strategy that adopts a rule-based trading mechanism that rather than striving to predict market direction or on information gathering to decide when to buy and when to sell a stock. Thus, in trend following one must respond to market’s movements that has recently happen and what is currently happening, rather than on what will happen. Optimally, in trend following strategy, is to catch a bull market at its early stage, ride the trend, and liquidate the position at the first evidence of the subsequent bear market. For applying the trend following strategy one needs to find the trend and identify trade signals. In order to avoid false signals, i.e., identify fluctuations of short, mid and long terms and to separate noise from real changes in the trend, most academic works rely on moving averages and other technical analysis indicators, such as the moving average convergence divergence (MACD) and the relative strength index (RSI) to uncover intelligible stock trading rules following trend following strategy philosophy. Recently, some works has applied machine learning techniques for trade rules discovery. In those works, the process of rule construction is based on evolutionary learning which aims to adapt the rules to the current environment and searches for the global optimum rules in the search space. In this work, instead of focusing on the usage of machine learning techniques for creating trading rules, a time series trend classification employing a semi-supervised approach was used to early identify both the beginning and the end of upward and downward trends. Such classification model can be employed to identify trade signals and the decision-making procedure is that if an up-trend (down-trend) is identified, a buy (sell) signal is generated. Semi-supervised learning is used for model training when only part of the data is labeled and Semi-supervised classification aims to train a classifier from both the labeled and unlabeled data, such that it is better than the supervised classifier trained only on the labeled data. For illustrating the proposed approach, it was employed daily trade information, including the open, high, low and closing values and volume from January 1, 2000 to December 31, 2022, of the São Paulo Exchange Composite index (IBOVESPA). Through this time period it was visually identified consistent changes in price, upwards or downwards, for assigning labels and leaving the rest of the days (when there is not a consistent change in price) unlabeled. For training the classification model, a pseudo-label semi-supervised learning strategy was used employing different technical analysis indicators. In this learning strategy, the core is to use unlabeled data to generate a pseudo-label for supervised training. For evaluating the achieved results, it was considered the annualized return and excess return, the Sortino and the Sharpe indicators. Through the evaluated time period, the obtained results were very consistent and can be considered promising for generating the intended trading signals.

Keywords: evolutionary learning, semi-supervised classification, time series data, trading signals generation

Procedia PDF Downloads 79
453 Sustainability in Higher Education: A Case of Transition Management from a Private University in Turkey (Ongoing Study)

Authors: Ayse Collins

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The Agenda 2030 puts Higher Education Institutions (HEIs) in the situation where they should emphasize ways to promote sustainability accordingly. However, it is still unclear: a) how sustainability is understood, and b) which actions have been taken in both discourse and practice by HEIs regarding the three pillars of sustainability, society, environment, and economy. There are models of sustainable universities developed by different authors from different countries; For Example, The Global Reporting Initiative (GRI) methodology which offers a variety of indicators to diagnose performance. However, these models have never been developed for universities in particular. Any model, in this sense, cannot be completed adequately without defining the appropriate tools to measure, analyze and control the performance of initiatives. There is a need to conduct researches in different universities from different countries to understand where we stand in terms of sustainable higher education. Therefore, this study aims at exploring the actions taken by a university in Ankara, Turkey, since Agenda 2030 should consider localizing its objectives and targets according to a certain geography. This university just announced 2021-2022 as “Sustainability Year.” Therefore, this research is a multi-methodology longitudinal study and uses the theoretical framework of the organization and transition management (TM). It is designed to examine the activities as being strategic, tactical, operational, and reflexive in nature and covers the six main aspects: academic community, administrative staff, operations and services, teaching, research, and extension. The preliminary research will answer the role of the top university governance, perception of the stakeholders (students, instructors, administrative and support staff) regarding sustainability, and the level of achievement at the mid-evaluation and final, end of year evaluation. TM Theory is a multi-scale, multi-actor, process-oriented approach with the analytical framework to explore and promote change in social systems. Therefore, the stages and respective methodology for collecting data in this research is: Pre-development Stage: a) semi-structured interviews with university governance, c) open-ended survey with faculty, students, and administrative staff d) Semi-structured interviews with support staff, and e) analysis of current secondary data for sustainability. Take-off Stage: a) semi-structured interviews with university governance, faculty, students, administrative and support staff, b) analysis of secondary data. Breakthrough stabilization a) survey with all stakeholders at the university, b) secondary data analysis by using selected indicators for the first sustainability report for universities The findings from the predevelopment stage highlight how stakeholders, coming from different faculties, different disciplines with different identities and characteristics, face the sustainability challenge differently. Though similar sustainable development goals ((social, environmental, and economic) are set in the institution, there are differences across disciplines and among different stakeholders, which need to be considered to reach the optimum goal. It is believed that the results will help changes in HEIs organizational culture to embed sustainability values in their strategic planning, academic and managerial work by putting enough time and resources to be successful in coping with sustainability.

Keywords: higher education, sustainability, sustainability auditing, transition management

Procedia PDF Downloads 102
452 From Theory to Practice: An Iterative Design Process in Implementing English Medium Instruction in Higher Education

Authors: Linda Weinberg, Miriam Symon

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While few institutions of higher education in Israel offer international programs taught entirely in English, many Israeli students today can study at least one content course taught in English during their degree program. In particular, with the growth of international partnerships and opportunities for student mobility, English medium instruction is a growing phenomenon. There are however no official guidelines in Israel for how to develop and implement content courses in English and no training to help lecturers prepare for teaching their materials in a foreign language. Furthermore, the implications for the students and the nature of the courses themselves have not been sufficiently considered. In addition, the institution must have lecturers who are able to teach these courses effectively in English. An international project funded by the European Union addresses these issues and a set of guidelines which provide guidance for lecturers in adapting their courses for delivery in English have been developed. A train-the-trainer approach is adopted in order to cascade knowledge and experience in English medium instruction from experts to language teachers and on to content teachers thus maximizing the scope of professional development. To accompany training, a model English medium course has been created which serves the dual purpose of highlighting alternatives to the frontal lecture while integrating language learning objectives with content goals. This course can also be used as a standalone content course. The development of the guidelines and of the course utilized backwards, forwards and central design in an iterative process. The goals for combined language and content outcomes were identified first after which a suitable framework for achieving these goals was constructed. The assessment procedures evolved through collaboration between content and language specialists and subsequently were put into action during a piloting phase. Feedback from the piloting teachers and from the students highlight the need for clear channels of communication to encourage frank and honest discussion of expectations versus reality. While much of what goes on in the English medium classroom requires no better teaching skills than are required in any classroom, the understanding of students' abilities in achieving reasonable learning outcomes in a foreign language must be rationalized and accommodated within the course design. Concomitantly, preparatory language classes for students must be able to adapt to prepare students for specific language and cognitive skills and activities that courses conducted in English require. This paper presents findings from the implementation of a purpose-designed English medium instruction course arrived at through an iterative backwards, forwards and central design process utilizing feedback from students and lecturers alike leading to suggested guidelines for English medium instruction in higher education.

Keywords: English medium instruction, higher education, iterative design process, train-the-trainer

Procedia PDF Downloads 296
451 The Role of High Schools in Saudi Arabia in Supporting Young Adults with Intellectual Disabilities with Their Transition to Post-secondary Education

Authors: Sohil I. Alqazlan

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Introduction and Objectives: There is limited research focusing on young adults with intellectual disabilities (ID) and their experiences after finishing compulsory education, especially in the Middle Eastern/Arab countries. This paper aims to further understand the lives of young adults with ID in Riyadh [the capital city of Saudi Arabia], particularly as they go on to access Post-Secondary Education [PSE]. As part of this study, it is important to understand the roles of high schools in Riyadh in terms of preparing their students for post-school life. To achieve this, the researcher has asked Saudi Arabia’s Ministry of Education to provide student transition plans (TPs) for post-school opportunities. However, and unfortunately, high schools in Riyadh do not use transition plans for their students. Therefore, the researcher has requested individual education plans (IEPs) for students with ID in their final year at high school to find the type of support the students had regarding both their long- and short-term goals that might help them access PSE or the labour market. Methods: The researcher analysed 10 IEPs of students in their final year at high school. To achieve the aim of the study, the researcher compared these IEPs with expectations set out in the official IEP framework of the MoE in Saudi Arabia, such as collaboration on the IEP sample and the focus on adult life. By analysing the students’ IEPs in terms of various goals, this study attempts to highlight skills that might offer students more independence after finishing compulsory education and going on to PSE. Results: Unfortunately, communication between IEP team members proved persistently absent in the sample. This was clear from the fact that none of the team members, apart from the SEN teachers, had signed any of the IEPs. Thus, none of the daily or weekly goals outlined were sent to parents to review at home. As a result of this, there were no goals in the IEPs that clearly referred to PSE. However, some long-term goals were set which might help those with ID become more independent in their adult life. For example, in the IEPs, which dealt with computer skills, the student had goals related to using Microsoft Word. Finally, just one goal of these IEPs set an important independent skill for the young adults with ID: “the student will learn how to use public transportation”. Conclusions: From analysing the ten IEPs, it was clear that SEN teachers in Riyadh schools were working without any help from other professionals. The students with ID, as well as their families, were not consulted on their views on important goals. Therefore, more work needs to be done with the students regarding their transition to PSE, perhaps by building partnerships between high schools and potential PSE institutions. Finally, more PSE programmes and a higher level of employer awareness could help create a bridge for students transferring from high school to PSE. Schools could also focus their IEP goals towards specific PSE programmes the student might attend, which could increase their chances of success.

Keywords: high school, post-secondary education, PSE, students with intellectual disabilities

Procedia PDF Downloads 163
450 Anti-tuberculosis, Resistance Modulatory, Anti-pulmonary Fibrosis and Anti-silicosis Effects of Crinum Asiaticum Bulbs and Its Active Metabolite, Betulin

Authors: Theophilus Asante, Comfort Nyarko, Daniel Antwi

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Drug-resistant tuberculosis, together with the associated comorbidities like pulmonary fibrosis and silicosis, has been one of the most serious global public health threats that requires immediate action to curb or mitigate it. This prolongs hospital stays, increases the cost of medication, and increases the death toll recorded annually. Crinum asiaticum bulb (CAE) and betulin (BET) are known for their biological and pharmacological effects. Pharmacological effects reported on CAE include antimicrobial, anti-inflammatory, anti-pyretic, anti-analgesic, and anti-cancer effects. Betulin has exhibited a multitude of powerful pharmacological properties ranging from antitumor, anti-inflammatory, anti-parasitic, anti-microbial, and anti-viral activities. This work sought to investigate the anti-tuberculosis and resistant modulatory effects and also assess their effects on mitigating pulmonary fibrosis and silicosis. In the anti-tuberculosis and resistant modulatory effects, both CAE and BET showed strong antimicrobial activities (31.25 ≤ MIC ≤ 500) µg/ml against the studied microorganisms and also produced significant anti-efflux pump and biofilm inhibitory effects (ρ < 0.0001) as well as exhibiting resistance modulatory and synergistic effects when combined with standard antibiotics. Crinum asiaticum bulbs extract and betulin were shown to possess anti-pulmonary fibrosis effects. There was an increased survival rate in the CAE and BET treatment groups compared to the BLM-induced group. There was a marked decrease in the levels of hydroxyproline and collagen I and III in the CAE and BET treatment groups compared to the BLM-treated group. The treatment groups of CAE and BET significantly downregulated the levels of pro-fibrotic and pro-inflammatory cytokine concentrations such as TGF-β1, MMP9, IL-6, IL-1β and TNF-alpha compared to an increase in the BLM-treated groups. The histological findings of the lungs suggested the curative effects of CAE and BET following BLM-induced pulmonary fibrosis in mice. The study showed improved lung functions with a wide focal area of viable alveolar spaces and few collagen fibers deposition on the lungs of the treatment groups. In the anti-silicosis and pulmonoprotective effects of CAE and BET, the levels of NF-κB, TNF-α, IL-1β, IL-6 and hydroxyproline, collagen types I and III were significantly reduced by CAE and BET (ρ < 0.0001). Both CAE and BET significantly (ρ < 0.0001) inhibited the levels of hydroxyproline, collagen I and III when compared with the negative control group. On BALF biomarkers such as macrophages, lymphocytes, monocytes, and neutrophils, CAE and BET were able to reduce their levels significantly (ρ < 0.0001). The CAE and BET were examined for anti-oxidant activity and shown to raise the levels of catalase (CAT) and superoxide dismutase (SOD) while lowering the level of malondialdehyde (MDA). There was an improvement in lung function when lung tissues were examined histologically. Crinum asiaticum bulbs extract and betulin were discovered to exhibit anti-tubercular and resistance-modulatory properties, as well as the capacity to minimize TB comorbidities such as pulmonary fibrosis and silicosis. In addition, CAE and BET may act as protective mechanisms, facilitating the preservation of the lung's physiological integrity. The outcomes of this study might pave the way for the development of leads for producing single medications for the management of drug-resistant tuberculosis and its accompanying comorbidities.

Keywords: fibrosis, crinum, tuberculosis, antiinflammation, drug resistant

Procedia PDF Downloads 79
449 The Effectiveness of Prenatal Breastfeeding Education on Breastfeeding Uptake Postpartum: A Systematic Review.

Authors: Jennifer Kehinde, Claire O'donnell, Annmarie Grealish

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Introduction: Breastfeeding has been shown to provide numerous health benefits for both infants and mothers. The decision to breastfeed is influenced by physiological, psychological, and emotional factors. However, the importance of equipping mothers with the necessary knowledge for successful breastfeeding practice cannot be ruled out. The decline in global breastfeeding rate can be linked to lack of adequate breastfeeding education during prenatal stage.This systematic review examined the effectiveness of prenatal breastfeeding education on breastfeeding uptake postpartum. Method: This review was undertaken and reported in conformity with the Preferred Reporting Items for Systemic Reviews and Meta-Analysis statement (PRISMA) and was registered on the international prospective register for systematic reviews (PROSPERO: CRD42020213853). A PICO analysis (population, intervention, comparison, outcome) was undertaken to inform the choice of keywords in the search strategy to formulate the review question which was aimed at determining the effectiveness of prenatal breastfeeding educational programs at improving breastfeeding uptake following birth. A systematic search of five databases (Cumulative Index to Nursing and Allied Health Literature, Medline, Psych INFO, and Applied Social Sciences Index and Abstracts) were searched between January 2014 until July 2021 to identify eligible studies. Quality assessment and narrative synthesis were subsequently undertaken. Results: Fourteen studies were included. All 14 studies used different types of breastfeeding programs; eight used a combination of curriculum based breastfeeding education program, group prenatal breastfeeding counselling and one-to-one breastfeeding educational programs which were all delivered in person; four studies used web-based learning platforms to deliver breastfeeding education prenatally which were both delivered online and face to face over a period of 3 weeks to 2 months with follow-up periods ranging from 3 weeks to 6 months; one study delivered breastfeeding educational intervention using mother-to-mother breastfeeding support groups in promoting exclusive breastfeeding and one study disseminated breastfeeding education to participants based on the theory of planned behaviour. The most effective interventions were those that included both theory and hands-on demonstrations. Results showed an increase in breastfeeding uptake, breastfeeding knowledge, increase in positive attitude to breastfeeding and an increase in maternal breastfeeding self-efficacy among mothers who participated in breastfeeding educational programs during prenatal care. Conclusion: Prenatal breastfeeding education increases women’s knowledge of breastfeeding. Mothers who are knowledgeable about breastfeeding and hold a positive approach towards breastfeeding have the tendency to initiate breastfeeding and continue for a lengthened period. Findings demonstrates a general correlation between prenatal breastfeeding education and increased breastfeeding uptake postpartum. The high level of positive breastfeeding outcome inherent in all the studies can be attributed to prenatal breastfeeding education. This review provides rigorous contemporary evidence that healthcare professionals and policymakers can apply when developing effective strategies to improve breastfeeding rates and ultimately improve the health outcomes of mothers and infants.

Keywords: breastfeeding, breastfeeding programs, breastfeeding self-efficacy, prenatal breastfeedng education

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448 Malaria Menace in Pregnancy; Hard to Ignore

Authors: Nautiyal Ruchira, Nautiyal Hemant, Chaudhury Devnanda, Bhargava Surbhi, Chauhan Nidhi

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Introduction: South East Asian region contributes 2.5 million cases of malaria each year to the global burden of 300 to 500 million of which 76% is reported from India. Government of India launched a national program almost half a century ago, still malaria remains a major public health challenge. Pregnant women are more susceptible to severe malaria and its fetomaternal complications. Inadequate surveillance and under-reporting underestimates the problem. Aim: Present study aimed to analyze the clinical course and pattern of malaria during pregnancy and to study the feto-maternal outcome. Methodology: This is a prospective observational study carried out at Himalayan Institute of Medical Sciences – a tertiary care center in the sub-Himalayan state of Uttarakhand, Northern India. All the pregnant women with malaria and its complications were recruited in the study during 2009 to 2014 which included referred cases from the state of western Uttar Pradesh. A thorough history and clinical examination were carried out to assess maternal and fetal condition. Relevant investigations including haemogram, platelet count, LFT, RFT, and USG was done. Blood slides and rapid diagnostic tests were done to diagnose the type of malaria.The primary outcomes measured were the type of malaria infection, maternal complications associated with malaria, outcome of pregnancy and effect on the fetus. Results: 67 antenatal cases with malaria infection were studied. 71% patients were diagnosed with plasmodium vivax infection, 25% cases were plasmodium falciparum positive and in 3% cases mixed infection was found. 38(56%) patients were primigravida and 29(43%) were multiparous. Most of the patients had already received some treatment from their local doctors and presented with severe malaria with the complications. Thrombocytopenia was the commonest manifestation seen in 35(52%) patients, jaundice in 28%, severe anemia in 18%, and severe oligohydramnios in 10% and renal failure in 6% cases. Regarding pregnancy outcome there were 44 % preterm deliveries, 22% had IUFD and abortions in 6% cases.20% of newborn were low birth weight and 6% were IUGR. There was only one maternal death which occurred due to ARDS in falciparum malaria. Although Plasmodium vivax was the main parasite considering the severity of clinical presentation, all the patients received intensive care. As most of the patients had received chloroquine therapy hence they were treated with IV artesunate followed by oral artemesinin combination therapy. Other therapies in the form of packed RBC’s and platelet transfusions, dialysis and ventilator support were provided when required. Conclusion: Even in areas with annual parasite index (API) less than 2 like ours, malaria in pregnancy could be an alarming problem. Vivax malaria cannot be considered benign in pregnancy because of high incidence of morbidity. Prompt diagnosis and aggressive treatment can reduce morbidity and mortality significantly. Increased community level research, integrating ANC checkups with the distribution of insecticide-treated nets in areas of high endemicity, imparting education and awareness will strengthen the existing control strategies.

Keywords: severe malaria, pregnancy, plasmodium vivax, plasmodium falciparum

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447 Metalorganic Chemical Vapor Deposition Overgrowth on the Bragg Grating for Gallium Nitride Based Distributed Feedback Laser

Authors: Junze Li, M. Li

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Laser diodes fabricated from the III-nitride material system are emerging solutions for the next generation telecommunication systems and optical clocks based on Ca at 397nm, Rb at 420.2nm and Yb at 398.9nm combined 556 nm. Most of the applications require single longitudinal optical mode lasers, with very narrow linewidth and compact size, such as communication systems and laser cooling. In this case, the GaN based distributed feedback (DFB) laser diode is one of the most effective candidates with gratings are known to operate with narrow spectra as well as high power and efficiency. Given the wavelength range, the period of the first-order diffraction grating is under 100 nm, and the realization of such gratings is technically difficult due to the narrow line width and the high quality nitride overgrowth based on the Bragg grating. Some groups have reported GaN DFB lasers with high order distributed feedback surface gratings, which avoids the overgrowth. However, generally the strength of coupling is lower than that with Bragg grating embedded into the waveguide within the GaN laser structure by two-step-epitaxy. Therefore, the overgrowth on the grating technology need to be studied and optimized. Here we propose to fabricate the fine step shape structure of first-order grating by the nanoimprint combined inductively coupled plasma (ICP) dry etching, then carry out overgrowth high quality AlGaN film by metalorganic chemical vapor deposition (MOCVD). Then a series of gratings with different period, depths and duty ratios are designed and fabricated to study the influence of grating structure to the nano-heteroepitaxy. Moreover, we observe the nucleation and growth process by step-by-step growth to study the growth mode for nitride overgrowth on grating, under the condition that the grating period is larger than the mental migration length on the surface. The AFM images demonstrate that a smooth surface of AlGaN film is achieved with an average roughness of 0.20 nm over 3 × 3 μm2. The full width at half maximums (FWHMs) of the (002) reflections in the XRD rocking curves are 278 arcsec for the AlGaN film, and the component of the Al within the film is 8% according to the XRD mapping measurement, which is in accordance with design values. By observing the samples with growth time changing from 200s, 400s to 600s, the growth model is summarized as the follow steps: initially, the nucleation is evenly distributed on the grating structure, as the migration length of Al atoms is low; then, AlGaN growth alone with the grating top surface; finally, the AlGaN film formed by lateral growth. This work contributed to carrying out GaN DFB laser by fabricating grating and overgrowth on the nano-grating patterned substrate by wafer scale, moreover, growth dynamics had been analyzed as well.

Keywords: DFB laser, MOCVD, nanoepitaxy, III-niitride

Procedia PDF Downloads 178
446 Development of a Context Specific Planning Model for Achieving a Sustainable Urban City

Authors: Jothilakshmy Nagammal

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This research paper deals with the different case studies, where the Form-Based Codes are adopted in general and the different implementation methods in particular are discussed to develop a method for formulating a new planning model. The organizing principle of the Form-Based Codes, the transect is used to zone the city into various context specific transects. An approach is adopted to develop the new planning model, city Specific Planning Model (CSPM), as a tool to achieve sustainability for any city in general. A case study comparison method in terms of the planning tools used, the code process adopted and the various control regulations implemented in thirty two different cities are done. The analysis shows that there are a variety of ways to implement form-based zoning concepts: Specific plans, a parallel or optional form-based code, transect-based code /smart code, required form-based standards or design guidelines. The case studies describe the positive and negative results from based zoning, Where it is implemented. From the different case studies on the method of the FBC, it is understood that the scale for formulating the Form-Based Code varies from parts of the city to the whole city. The regulating plan is prepared with the organizing principle as the transect in most of the cases. The various implementation methods adopted in these case studies for the formulation of Form-Based Codes are special districts like the Transit Oriented Development (TOD), traditional Neighbourhood Development (TND), specific plan and Street based. The implementation methods vary from mandatory, integrated and floating. To attain sustainability the research takes the approach of developing a regulating plan, using the transect as the organizing principle for the entire area of the city in general in formulating the Form-Based Codes for the selected Special Districts in the study area in specific, street based. Planning is most powerful when it is embedded in the broader context of systemic change and improvement. Systemic is best thought of as holistic, contextualized and stake holder-owned, While systematic can be thought of more as linear, generalisable, and typically top-down or expert driven. The systemic approach is a process that is based on the system theory and system design principles, which are too often ill understood by the general population and policy makers. The system theory embraces the importance of a global perspective, multiple components, interdependencies and interconnections in any system. In addition, the recognition that a change in one part of a system necessarily alters the rest of the system is a cornerstone of the system theory. The proposed regulating plan taking the transect as an organizing principle and Form-Based Codes to achieve sustainability of the city has to be a hybrid code, which is to be integrated within the existing system - A Systemic Approach with a Systematic Process. This approach of introducing a few form based zones into a conventional code could be effective in the phased replacement of an existing code. It could also be an effective way of responding to the near-term pressure of physical change in “sensitive” areas of the community. With this approach and method the new Context Specific Planning Model is created towards achieving sustainability is explained in detail this research paper.

Keywords: context based planning model, form based code, transect, systemic approach

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445 Healing (in) Relationship: The Theory and Practice of Inner-Outer Peacebuilding in North-Western India

Authors: Josie Gardner

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The overall intention of this research is to reimagine peacebuilding in both in theory and practical application in light of the shortcomings and unsustainability of the current peacebuilding paradigm. These limitations are identified here as an overly rational-material approach to peacebuilding that neglects the inner dimension of peace for a fragmented rather than holistic model, and that espouses a conflict and violence-centric approach to peacebuilding. In counter, this presentation is purposed to investigate the dynamics of inner and outer peace as a holistic, complex system towards ‘inner-outer’ peacebuilding. This paper draws from primary research in the protracted conflict context of north-western India (Jammu, Kashmir & Ladakh) as a case study. This presentation has two central aims. First, to introduce the process of inner (psycho-spiritual) peacebuilding, which has thus far been neglected by mainstream and orthodox literature. Second, to examine why inner peacebuilding is essential for realising sustainable peace on a broader scale as outer (socio-political) peace and to better understand how the inner and outer dynamics of peace relate and affect one another. To these ends, Josephine (the researcher/author/presenter) partnered with Yakjah Reconciliation and Development Network to implement a series of action-oriented workshops and retreats centred around healing, reconciliation, leadership, and personal development for the dual purpose of collaboratively generating data, theory, and insights, as well as providing the youth leaders with an experiential, transformative experience. The research team created and used a novel methodological approach called Mapping Ritual Ecologies, which draws from Participatory Action Research and Digital Ethnography to form a collaborative research model with a group of 20 youth co-researchers who are emerging youth peace leaders in Kashmir, Jammu, and Ladakh. This research found significant intra- and inter-personal shifts towards an experience of inner peace through inner peacebuilding activities. Moreover, this process of inner peacebuilding affected their families and communities through interpersonal healing and peace leadership in an inside-out process of change. These insights have generated rich insights and have supported emerging theories about the dynamics between inner and outer peace, power, justice, and collective healing. This presentation argues that the largely neglected dimension of inner (psycho-spiritual) peacebuilding is imperative for broader socio-political (outer) change. Changing structures of oppression, injustice, and violence—i.e. structures of separation—requires individual, interpersonal, and collective healing. While this presentation primarily examines and advocates for inside-out peacebuilding and social justice, it will also touch upon the effect of systems of separation on the inner condition and human experience. This research reimagines peacebuilding as a holistic inner-outer approach. This offers an alternative path forward those weaves together self-actualisation and social justice. While contextualised within north-western India with a small case study population, the findings speak also to other conflict contexts as well as our global peacebuilding and social justice milieu.

Keywords: holistic, inner peacebuilding, psycho-spiritual, systems youth

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444 In Vitro Fermentation Of Rich In B-glucan Pleurotus Eryngii Mushroom: Impact On Faecal Bacterial Populations And Intestinal Barrier In Autistic Children

Authors: Georgia Saxami, Evangelia N. Kerezoudi, Evdokia K. Mitsou, Marigoula Vlassopoulou, Georgios Zervakis, Adamantini Kyriacou

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Autism Spectrum Disorder (ASD) is a complex group of developmental disorders of the brain, characterized by social and communication dysfunctions, stereotypes and repetitive behaviors. The potential interaction between gut microbiota (GM) and autism has not been fully elucidated. Children with autism often suffer gastrointestinal dysfunctions, while alterations or dysbiosis of GM have also been observed. Treatment with dietary components has been postulated to regulate GM and improve gastrointestinal symptoms, but there is a lack of evidence for such approaches in autism, especially for prebiotics. This study assessed the effects of Pleurotus eryngii mushroom (candidate prebiotic) and inulin (known prebiotic compound) on gut microbial composition, using faecal samples from autistic children in an in vitro batch culture fermentation system. Selected members of GM were enumerated at baseline (0 h) and after 24 h fermentation by quantitative PCR. After 24 h fermentation, inulin and P. eryngii mushroom induced a significant increase in total bacteria and Faecalibacterium prausnitzii compared to the negative control (gut microbiota of each autistic donor with no carbohydrate source), whereas both treatments induced a significant increase in levels of total bacteria, Bifidobacterium spp. and Prevotella spp. compared to baseline (t=0h) (p for all <0.05). Furthermore, this study evaluated the impact of fermentation supernatants (FSs), derived from P. eryngii mushroom or inulin, on the expression levels of tight junctions’ genes (zonulin-1, occludin and claudin-1) in Caco-2 cells stimulated by bacterial lipopolysaccharides (LPS). Pre-incubation of Caco-2 cells with FS from P. eryngii mushroom led to a significant increase in the expression levels of zonulin-1, occludin and claudin-1 genes compared to the untreated cells, the cells that were subjected to LPS and the cells that were challenged with FS from negative control (p for all <0.05). In addition, incubation with FS from P. eryngii mushroom led to the highest mean expression values for zonulin-1 and claudin-1 genes, which differed significantly compared to inulin (p for all <0.05). Overall, this research highlighted the beneficial in vitro effects of P. eryngii mushroom on the composition of GM of autistic children after 24 h of fermentation. Also, our data highlighted the potential preventive effect of P. eryngii FSs against dysregulation of the intestinal barrier, through upregulation of tight junctions’ genes associated with the integrity and function of the intestinal barrier. This research has been financed by "Supporting Researchers with Emphasis on Young Researchers - Round B", Operational Program "Human Resource Development, Education and Lifelong Learning."

Keywords: gut microbiota, intestinal barrier, autism spectrum disorders, Pleurotus Eryngii

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443 A Culture-Contrastive Analysis Of The Communication Between Discourse Participants In European Editorials

Authors: Melanie Kerschner

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Language is our main means of social interaction. News journalism, especially opinion discourse, holds a powerful position in this context. Editorials can be regarded as encounters of different, partially contradictory relationships between discourse participants constructed through the editorial voice. Their primary goal is to shape public opinion by commenting on events already addressed by other journalistic genres in the given newspaper. In doing so, the author tries to establish a consensus over the negotiated matter (i.e. the news event) with the reader. At the same time, he/she claims authority over the “correct” description and evaluation of an event. Yet, how can the relationship and the interaction between the discourse participants, i.e. the journalist, the reader and the news actors represented in the editorial, be best visualized and studied from a cross-cultural perspective? The present research project attempts to give insights into the role of (media) culture in British, Italian and German editorials. For this purpose the presenter will propose a basic framework: the so called “pyramid of discourse participants”, comprising the author, the reader, two types of news actors and the semantic macro-structure (as meta-level of analysis). Based on this framework, the following questions will be addressed: • Which strategies does the author employ to persuade the reader and to prompt him to give his opinion (in the comment section)? • In which ways (and with which linguistic tools) is editorial opinion expressed? • Does the author use adjectives, adverbials and modal verbs to evaluate news actors, their actions and the current state of affairs or does he/she prefer nominal labels? • Which influence do language choice and the related media culture have on the representation of news events in editorials? • In how far does the social context of a given media culture influence the amount of criticism and the way it is mediated so that it is still culturally-acceptable? The following culture-contrastive study shall examine 45 editorials (i.e. 15 per media culture) from six national quality papers that are similar in distribution, importance and the kind of envisaged readership to make valuable conclusions about culturally-motivated similarities and differences in the coverage and assessment of news events. The thematic orientation of the editorials will be the NSA scandal and the reactions of various countries, as this topic was and still is relevant to each of the three media cultures. Starting out from the “pyramid of discourse participants” as underlying framework, eight different criteria will be assigned to the individual discourse participants in the micro-analysis of the editorials. For the purpose of illustration, a single criterion, referring to the salience of authorial opinion, will be selected to demonstrate how the pyramid of discourse participants can be applied as a basis for empirical analysis. Extracts from the corpus shall furthermore enhance the understanding.

Keywords: Micro-analysis of editorials, culture-contrastive research, media culture, interaction between discourse participants, evaluation

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442 Preliminary Evaluation of Echinacea Species by UV-VIS Spectroscopy Fingerprinting of Phenolic Compounds

Authors: Elena Ionescu, Elena Iacob, Marie-Louise Ionescu, Carmen Elena Tebrencu, Oana Teodora Ciuperca

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Echinacea species (Asteraceae) has received a global attention because it is widely used for treatment of cold, flu and upper respiratory tract infections. Echinacea species contain a great variety of chemical components that contribute to their activity. The most important components responsible for the biological activity are those with high molecular-weight such as polysaccharides, polyacetylenes, highly unsaturated alkamides and caffeic acid derivatives. The principal factors that may influence the chemical composition of Echinacea include the species and the part of plant used (aerial parts or roots ). In recent years the market for Echinacea has grown rapidly and also the cases of adultery/replacement especially for Echinacea root. The identification of presence or absence of same biomarkers provide information for safe use of Echinacea species in food supplements industry. The aim of the study was the preliminary evaluation and fingerprinting by UV-VISIBLE spectroscopy of biomarkers in terms of content in phenolic derivatives of some Echinacea species (E. purpurea, E. angustifolia and E. pallida) for identification and authentication of the species. The steps of the study were: (1) samples (extracts) preparation from Echinacea species (non-hydrolyzed and hydrolyzed ethanol extracts); (2) samples preparation of reference substances (polyphenol acids: caftaric acid, caffeic acid, chlorogenic acid, ferulic acid; flavonoids: rutoside, hyperoside, isoquercitrin and their aglycones: quercitri, quercetol, luteolin, kaempferol and apigenin); (3) identification of specific absorption at wavelengths between 700-200 nm; (4) identify the phenolic compounds from Echinacea species based on spectral characteristics and the specific absorption; each class of compounds corresponds to a maximum absorption in the UV spectrum. The phytochemical compounds were identified at specific wavelengths between 700-200 nm. The absorption intensities were measured. The obtained results proved that ethanolic extract showed absorption peaks attributed to: phenolic compounds (free phenolic acids and phenolic acids derivatives) registrated between 220-280 nm, unsymmetrical chemical structure compounds (caffeic acid, chlorogenic acid, ferulic acid) with maximum absorption peak and absorption "shoulder" that may be due to substitution of hydroxyl or methoxy group, flavonoid compounds (in free form or glycosides) between 330-360 nm, due to the double bond in position 2,3 and carbonyl group in position 4 flavonols. UV spectra showed two major peaks of absorption (quercetin glycoside, rutin, etc.). The results obtained by UV-VIS spectroscopy has revealed the presence of phenolic derivatives such as cicoric acid (240 nm), caftaric acid (329 nm), caffeic acid (240 nm), rutoside (205 nm), quercetin (255 nm), luteolin (235 nm) in all three species of Echinacea. The echinacoside is absent. This profile mentioned above and the absence of phenolic compound echinacoside leads to the conclusion that species harvested as Echinacea angustifolia and Echinacea pallida are Echinacea purpurea also; It can be said that preliminary fingerprinting of Echinacea species through correspondence with the phenolic derivatives profile can be achieved by UV-VIS spectroscopic investigation, which is an adequate technique for preliminary identification and authentication of Echinacea in medicinal herbs.

Keywords: Echinacea species, Fingerprinting, Phenolic compounds, UV-VIS spectroscopy

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441 Turkish Airlines' 85th Anniversary Commercial: An Analysis of the Institutional Identity of a Brand in Terms of Glocalization

Authors: Samil Ozcan

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Airlines companies target different customer segments in consideration of pricing, service quality, flight network, etc. and their brand positioning accords with the marketization strategies developed in the same direction. The object of this study, Turkish Airlines, has many peculiarities regarding its brand positioning as compared to its rivals in the sector. In the first place, it appeals to a global customer group because of its Star Alliance membership and its broad flight network with 315 destination points. The second group in its customer segmentation includes domestic customers. For this group, the company follows a marketing strategy that plays to local culture and accentuates the image of Turkishness as an emotional allurement. The advertisements and publicity projects designed in this regard put little emphasis on the service quality the company offers to its clients; it addresses the emotions of the consumers rather than individual benefits and relies on the historical memory of the nation and shared cultural values. This study examines the publicity work which aims at the second segment customer group focusing on Turkish Airlines’ 85th Anniversary Commercial through a symbolic meaning analysis approach. The commercial presents six stories with undertones of nationalism in its theme. Nationalism is not just the product of collective interests based on reason but a result of patriotism in the sense of loyalty to state and nation and love of ethnic belonging. While nationalism refers to concrete notions such as blood tie, common ancestor, shared history, it is not the actuality of these notions that it draws its real strength but the emotions invested in them. The myths of origin, the idea of common homeland, boundary definitions, and symbolic acculturation have instrumental importance in the development of these commonalities. The commercial offers concrete examples for an analysis of Connor’s definition of nationalism based on emotions. Turning points in the history of the Turkish Republic and the historical mission Turkish Airlines undertook in these moments are narrated in six stories in the commercial with a highly emotional theme. These emotions, in general, depend on collective memory generated by national consciousness. Collective memory is not simply remembering the past. It is constructed through the reconstruction and reinterpretation of the past in the present moment. This study inquires the motivations behind the nationalist emotions generated within the collective memory by engaging with the commercial released for the 85th anniversary of Turkish Airlines as the object of analysis. Symbols and myths can be read as key concepts that reveal the relation between 'identity and memory'. Because myths and symbols do not merely reflect on collective memory, they reconstruct it as well. In this sense, the theme of the commercial defines the image of Turkishness with virtues such as self-sacrifice, helpfulness, humanity, and courage through a process of meaning creation based on symbolic mythologizations like flag and homeland. These virtues go beyond describing the image of Turkishness and become an instrument that defines and gives meaning to Turkish identity.

Keywords: collective memory, emotions, identity, nationalism

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440 Health Inequalities in the Global South: Identification of Poor People with Disabilities in Cambodia to Generate Access to Healthcare

Authors: Jamie Lee Harder

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In the context of rapidly changing social and economic circumstances in the developing world, this paper analyses access to public healthcare for poor people with disabilities in Cambodia. Like other countries of South East Asia, Cambodia is developing at rapid pace. The historical past of Cambodia, however, has set former social policy structures to zero. This past forces Cambodia and its citizens to implement new public health policies to align with the needs of social care, healthcare, and urban planning. In this context, the role of people with disabilities (PwDs) is crucial as new developments should and can take into consideration their specific needs from the beginning onwards. This paper is based on qualitative research with expert interviews and focus group discussions in Cambodia. During the field work it became clear that the identification tool for the poorest households (HHs) does not count disability as a financial risk to fall into poverty neither when becoming sick nor because of higher health expenditures and/or lower income because of the disability. The social risk group of poor PwDs faces several barriers in accessing public healthcare. The urbanization, the socio-economic health status, and opportunities for education; all influence social status and have an impact on the health situation of these individuals. Cambodia has various difficulties with providing access to people with disabilities, mostly due to barriers regarding finances, geography, quality of care, poor knowledge about their rights and negative social and cultural beliefs. Shortened budgets and the lack of prioritizations lead to the need for reorientation of local communities, international and national non-governmental organizations and social policy. The poorest HHs are identified with a questionnaire, the IDPoor program, for which the Ministry of Planning is responsible. The identified HHs receive an ‘Equity Card’ which provides access free of charge to public healthcare centers and hospitals among other benefits. The dataset usually does not include information about the disability status. Four focus group discussions (FGD) with 28 participants showed various barriers in accessing public healthcare. These barriers go far beyond a missing ramp to access the healthcare center. The contents of the FGDs were ratified and repeated during the expert interviews with the local Ministries, NGOs, international organizations and private persons working in the field. The participants of the FGDs faced and continue to face high discrimination, low capacity to work and earn an own income, dependency on others and less social competence in their lives. When discussing their health situation, we identified, a huge difference between those who are identified and hold an Equity Card and those who do not. Participants reported high costs without IDPoor identification, positive experiences when going to the health center in terms of attitude and treatment, low satisfaction with specific capacities for treatments, negative rumors, and discrimination with the consequence of fear to seek treatment in many cases. The problem of accessing public healthcare by risk groups can be adapted to situations in other countries.

Keywords: access, disability, health, inequality, Cambodia

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439 Maternal and Newborn Health Care Program Implementation and Integration by Maternal Community Health Workers, Africa: An Integrative Review

Authors: Nishimwe Clemence, Mchunu Gugu, Mukamusoni Dariya

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Background: Community health workers and extension workers can play an important role in supporting families to adopt health practices, encourage delivery in a health care facility, and ensure time referral of mothers and newborns if needed. Saving the lives of neonates should, therefore, be a significant health outcome in any maternal and newborn health program that is being implemented. Furthermore, about half of a million mothers die from pregnancy-related causes. Maternal and newborn deaths related to the period of postnatal care are neglected. Some authors emphasized that in developing countries, newborn mortality rates have been reduced much more slowly because of the lack of many necessary facility-based and outreach service. The aim of this review was to critically analyze the implementation and integration process of the maternal and newborn health care program by maternal community health workers, into the health care system, in Africa. Furthermore, it aims to reduce maternal and newborn mortality. We addressed the following review question: (1) what process is involved in the implementation and integration of the maternal and newborn health care program by maternal community health workers during antenatal, delivery and postnatal care into health system care in Africa? Methods: The database searched was from Health Source: Nursing/Academic Edition through academic search complete via EBSCO Host. An iterative approach was used to go through Google scholarly papers. The reviewers considered adapted Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidance, and the Mixed Methods Appraisal Tool (MMAT) was used. Synthesis method in integrative review following elements of noting patterns and themes, seeing plausibility, clustering, counting, making contrasts and comparisons, discerning commons and unusual patterns, subsuming particulars into general, noting relations between variability, finding intervening factors and building a logical chain of evidence, using data–based convergent synthesis design. Results: From the seventeen of studies included, results focused on three dimensions inspired by the literature on antenatal, delivery, and postnatal interventions. From this, further conceptual framework was elaborated. The conceptual framework process of implementation and integration of maternal and newborn health care program by maternal community health workers was elaborated in order to ensure the sustainability of community based intervention. Conclusions: the review revealed that the implementation and integration of maternal and newborn health care program require planning. We call upon governments, non-government organizations, the global health community, all stakeholders including policy makers, program managers, evaluators, educators, and providers to be involved in implementation and integration of maternal and newborn health program in updated policy and community-based intervention. Furthermore, emphasis should be placed on competence, responsibility, and accountability of maternal community health workers, their training and payment, collaboration with health professionals in health facilities, and reinforcement of outreach service. However, the review was limited in focus to the African context, where the process of maternal and newborn health care program has been poorly implemented.

Keywords: Africa, implementation of integration, maternal, newborn

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