Search results for: life assessment
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 12087

Search results for: life assessment

11247 The Child Attachment Interview: A Psychometric Longitudinal Validation Study in a German Sample

Authors: Jorn Meyer, Stefan Sturmer

Abstract:

The assessment of attachment patterns in toddlers and adults has been well researched, and valid diagnostic methods (e.g., Strange Situation Test, Adult Attachment Interview) are applicable. For middle and late childhood, on the other hand, there are only few validated methods available so far. For the Child Attachment Interview (CAI) promising validation studies from English-speaking countries are available, but so far a comprehensive study on the validity of a German sample is lacking. Within the scope of a longitudinal project, the results of the first point of measurement are reported in this study. A German-language version of the CAI was carried out with 111 primary school children (56% female; age: M = 8.34, SD = 0.49). In relation to psychometric quality criteria, parameters on interrater reliability, construct validity and discriminant, and convergent validity are reported. Analyses of the correlations between attachment patterns and internalizing and externalizing behavior problems from parent and teacher reports are presented. The implications for the German-language assessment of attachment in middle and late childhood in research and individual case diagnostics, e.g., in the context of conducting expert evaluation reports for family courts, are discussed.

Keywords: attachment, attachment assessment, developmental psychology, longitudinal study

Procedia PDF Downloads 221
11246 Electroencephalography-Based Intention Recognition and Consensus Assessment during Emergency Response

Authors: Siyao Zhu, Yifang Xu

Abstract:

After natural and man-made disasters, robots can bypass the danger, expedite the search, and acquire unprecedented situational awareness to design rescue plans. The hands-free requirement from the first responders excludes the use of tedious manual control and operation. In unknown, unstructured, and obstructed environments, natural-language-based supervision is not amenable for first responders to formulate, and is difficult for robots to understand. Brain-computer interface is a promising option to overcome the limitations. This study aims to test the feasibility of using electroencephalography (EEG) signals to decode human intentions and detect the level of consensus on robot-provided information. EEG signals were classified using machine-learning and deep-learning methods to discriminate search intentions and agreement perceptions. The results show that the average classification accuracy for intention recognition and consensus assessment is 67% and 72%, respectively, proving the potential of incorporating recognizable users’ bioelectrical responses into advanced robot-assisted systems for emergency response.

Keywords: consensus assessment, electroencephalogram, emergency response, human-robot collaboration, intention recognition, search and rescue

Procedia PDF Downloads 70
11245 Robustified Asymmetric Logistic Regression Model for Global Fish Stock Assessment

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

Abstract:

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

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

Procedia PDF Downloads 250
11244 Damage Assessment of Current Facades in Turkey throughout the Seismic Actions

Authors: Büşra Elibol, İsmail Sait Soyer, Hamid Farrokh Ghatte

Abstract:

The continuity of the structural and non-structural elements within the envelope of the buildings is one of the fundamental factors in buildings during seismic actions. This investigation aims to make a comparison between Van and İzmir earthquakes in terms of damage assessment of the various facades. A strong earthquake (magnitude 7.2) struck the city of Van in the east of Turkey on 23 October 2011, and similarly, another strong earthquake struck the city of İzmir (magnitude 6.9) in Turkey on 30 October 2020. This paper presents the damage assessment of the current facade systems from multi-story buildings in Van and İzmir, Turkey. This investigation covers the buildings greater than three stories in height, excluding most unreinforced masonry facades. Regarding a building that can have more than one facade system, any of the facade systems are considered individually. Observation of different kinds of damages in the facade is discussed and represented in terms of its performance level throughout the seismic actions. Furthermore, presenting the standard design guidelines (i.e., Turkish seismic design code) is required not only for designers but also for installers of facade systems.

Keywords: damage, earthquake, facade, structural element, seismic action

Procedia PDF Downloads 143
11243 Forecasting Impacts on Vulnerable Shorelines: Vulnerability Assessment Along the Coastal Zone of Messologi Area - Western Greece

Authors: Evangelos Tsakalos, Maria Kazantzaki, Eleni Filippaki, Yannis Bassiakos

Abstract:

The coastal areas of the Mediterranean have been extensively affected by the transgressive event that followed the Last Glacial Maximum, with many studies conducted regarding the stratigraphic configuration of coastal sediments around the Mediterranean. The coastal zone of the Messologi area, western Greece, consists of low relief beaches containing low cliffs and eroded dunes, a fact which, in combination with the rising sea level and tectonic subsidence of the area, has led to substantial coastal. Coastal vulnerability assessment is a useful means of identifying areas of coastline that are vulnerable to impacts of climate change and coastal processes, highlighting potential problem areas. Commonly, coastal vulnerability assessment takes the form of an ‘index’ that quantifies the relative vulnerability along a coastline. Here we make use of the coastal vulnerability index (CVI) methodology by Thieler and Hammar-Klose, by considering geological features, coastal slope, relative sea-level change, shoreline erosion/accretion rates, and mean significant wave height as well as mean tide range to assess the present-day vulnerability of the coastal zone of Messologi area. In light of this, an impact assessment is performed under three different sea level rise scenarios, and adaptation measures to control climate change events are proposed. This study contributes toward coastal zone management practices in low-lying areas that have little data information, assisting decision-makers in adopting best adaptations options to overcome sea level rise impact on vulnerable areas similar to the coastal zone of Messologi.

Keywords: coastal vulnerability index, coastal erosion, sea level rise, GIS

Procedia PDF Downloads 159
11242 Assessing the Disability-Free Life Expectancy and Decomposition of Its Difference: A Gender Perspective on India over the Decade 2001-2011

Authors: Kajori Banerjee, Laxmi Kant Dwivedi

Abstract:

“Health transition” is defined to be “a process through which high levels of mortality, morbidity and disability are reduced to low levels by influencing cultural, social and behavioural factors”. Life expectancy in India has been on the rise and parallel the burden of disease and disability has also risen noticeably. Borrowing data from Indian Census (2001, 2011), this study identifies the gender-wise burden of disability by calculating disability free life expectancy (DFLE) and life lived with disability (LWD). Sullivan’s method of calculating DFLE using proportion of disabled is used for this purpose. The change in person years lived with disability in the decade 2001-11 is further decomposed using Arriaga’s method into mortality and disability effects (ME and DE) to check the magnitude and direction of contribution of mortality and disability. Nationally, along with DFLE, LWD has amplified too. Despite having the highest life expectancy and DFLE, LWD in Kerala, was highest for both sexes in 2001. But in 2011, the LWD was highest among the males of Orissa and females of Rajasthan. For the overall population, DE is positive for the prime working age groups of 20-40years indicating that there has been an increase in the disability proportion holding mortality constant for 2001-2011. Females exhibit higher positive DE implying greater loss of healthy years due to disability than males. The findings call for an immediate attention to the causes of rising disability burden among the working population, especially females, as this might heavily effect the availability of quality labour force and its relative economic output in the Indian labour market. This also hints at the degrading quality of the elongated life and needs to be given the required attention to enhance the quality of life lead in the Nation.

Keywords: disability-free life expectancy, disability effect, life expectancy, mortality effect

Procedia PDF Downloads 374
11241 Heavy Metal Contents in Vegetable Oils of Kazakhstan Origin and Life Risk Assessment

Authors: A. E. Mukhametov, M. T. Yerbulekova, D. R. Dautkanova, G. A. Tuyakova, G. Aitkhozhayeva

Abstract:

The accumulation of heavy metals in food is a constant problem in many parts of the world. Vegetable oils are widely used, both for cooking and for processing in the food industry, meeting the main dietary requirements. One of the main chemical pollutants, heavy metals, is usually found in vegetable oils. These chemical pollutants are carcinogenic, teratogenic and immunotoxic, harmful to consumption and have a negative effect on human health even in trace amounts. Residues of these substances can easily accumulate in vegetable oil during cultivation, processing and storage. In this article, the content of the concentration of heavy metal ions in vegetable oils of Kazakhstan production is studied: sunflower, rapeseed, safflower and linseed oil. Heavy metals: arsenic, cadmium, lead and nickel, were determined in three repetitions by the method of flame atomic absorption. Analysis of vegetable oil samples revealed that the largest lead contamination (Pb) was determined to be 0.065 mg/kg in linseed oil. The content of cadmium (Cd) in the largest amount of 0.009 mg/kg was found in safflower oil. Arsenic (As) content was determined in rapeseed and safflower oils at 0.003 mg/kg, and arsenic (As) was not detected in linseed and sunflower oil. The nickel (Ni) content in the largest amount of 0.433 mg/kg was in linseed oil. The heavy metal contents in the test samples complied with the requirements of regulatory documents for vegetable oils. An assessment of the health risk of vegetable oils with a daily consumption of 36 g per day shows that all samples of vegetable oils produced in Kazakhstan are safe for consumption. But further monitoring is needed, since all these metals are toxic and their harmful effects become apparent only after several years of exposure.

Keywords: vegetable oil, sunflower oil, linseed oil, safflower oil, toxic metals, food safety, rape oil

Procedia PDF Downloads 116
11240 The Appropriate Number of Test Items That a Classroom-Based Reading Assessment Should Include: A Generalizability Analysis

Authors: Jui-Teng Liao

Abstract:

The selected-response (SR) format has been commonly adopted to assess academic reading in both formal and informal testing (i.e., standardized assessment and classroom assessment) because of its strengths in content validity, construct validity, as well as scoring objectivity and efficiency. When developing a second language (L2) reading test, researchers indicate that the longer the test (e.g., more test items) is, the higher reliability and validity the test is likely to produce. However, previous studies have not provided specific guidelines regarding the optimal length of a test or the most suitable number of test items or reading passages. Additionally, reading tests often include different question types (e.g., factual, vocabulary, inferential) that require varying degrees of reading comprehension and cognitive processes. Therefore, it is important to investigate the impact of question types on the number of items in relation to the score reliability of L2 reading tests. Given the popularity of the SR question format and its impact on assessment results on teaching and learning, it is necessary to investigate the degree to which such a question format can reliably measure learners’ L2 reading comprehension. The present study, therefore, adopted the generalizability (G) theory to investigate the score reliability of the SR format in L2 reading tests focusing on how many test items a reading test should include. Specifically, this study aimed to investigate the interaction between question types and the number of items, providing insights into the appropriate item count for different types of questions. G theory is a comprehensive statistical framework used for estimating the score reliability of tests and validating their results. Data were collected from 108 English as a second language student who completed an English reading test comprising factual, vocabulary, and inferential questions in the SR format. The computer program mGENOVA was utilized to analyze the data using multivariate designs (i.e., scenarios). Based on the results of G theory analyses, the findings indicated that the number of test items had a critical impact on the score reliability of an L2 reading test. Furthermore, the findings revealed that different types of reading questions required varying numbers of test items for reliable assessment of learners’ L2 reading proficiency. Further implications for teaching practice and classroom-based assessments are discussed.

Keywords: second language reading assessment, validity and reliability, Generalizability theory, Academic reading, Question format

Procedia PDF Downloads 64
11239 Making a Difference in a Crisis: How the 24-Hour Surgical Ambulatory Assessment Unit Transformed Emergency Care during COVID-19

Authors: Bindhiya Thomas, Rehana Hafeez

Abstract:

Background: The Surgical Ambulatory Unit (SAU) also known as the Same Day Emergency Care (SDEC) is an established part of many hospitals providing same day emergency care service to surgical patients who would have otherwise required admission through the A&E. Prior to Covid, the SAU was functioning as a 12-hour service, but during the Covid crisis this service was transformed to a 24 hour functioning Surgical Ambulatory Assessment unit (SAAU). We studied the effects that this change brought about in-patient care in our hospital. Objective: The objective of the study was to assess the impact of a 24-hour Surgical Ambulatory Assessment unit on patient care during the time of Covid, in particular its role in freeing A&E capacity and delivering effective patient care. Methods: We collected two sets of data retrospectively. The first set was collected over a 6-week period when the SAU was functioning at the Princess Royal University Hospital. On March 23rd, 2020, the SAU was transformed into a 24-hour SAAU. Following this transformation, a second set of patient data was collected over a period of 6 weeks. A comparison was made between data collected from when the hospital had a 12-hour Surgical Ambulatory unit and later when it was transformed into a 24-hour facility. Its effects on the change in the number of patients breaching the four hour waiting period and the number of emergency surgical admissions. Results: The 24-hour Surgical Ambulatory Assessment unit brought significant reductions in the number of patients breaching the waiting period of 4 hours in A&E from 44% during the period of the 12-hour Surgical Ambulatory care facility to 0% from when the 24-hour Surgical Ambulatory Assessment Unit was established. A 28% reduction was also seen in the number of surgical patients' admissions from A&E. Conclusions: The 24-hour SAAU was found to have a profound positive impact on emergency care of surgical patients. Especially during the Covid crisis, it played a crucial role in providing not only effective and accessible patient care but also in reducing the A&E workload and admissions. It thus proved to be a strategic tool that helped to deal with the immense workload in emergency care during the Covid crisis and helped free much needed headspace at a time of uncertainty for the A&E to better configure their services. If sustained, the 24-hour SAAU could be relied on to augment the NHS emergency services in the future, especially in the event of another crisis.

Keywords: Princess Royal University Hospital, surgical ambulatory assessment unit, surgical ambulatory unit, same day emergency care

Procedia PDF Downloads 144
11238 A Study of Mental Health of Wife of Patients with HIV+ and Effects of Life Skills on Promotion of Their Mental Health

Authors: Ali Karimi, Shabnam Karimifam, Amirhosein Karimi, Farahnaz Pournavvab

Abstract:

Researches have emphasis on the important role of psychosocial support and appropriate interventions for individuals that involved in serious physical and psychological problems . Patients with AIDS are often discussed in studies, but sometimes the psychological conditions of the people who live with them are ignored. In the present study, while paying attention to the spouses of AIDS patients, the role of supportive interventions has been investigated. the other word , Researchers Show that life skills training causes significant improvement in the mean scores of mothers physical health , mental health, social relationship and ultimately quality of life in the experimental group . The purpose of this study is determine of mental health of Twenty-one wives of patients with HIV+ In Shiraz ( city in sought of Iran) and effects of life skills on promotion of their mental health . Sampling was systematic randomize . These women were selected and invited to the training program based on their husbands' file numbers, who were selected to the counseling center for people with AIDS. first , they filled out GHQ questionnaires . Then , the life skills training for 8 sessions were taught for these women . Results indicated that Psychological condition of wife of patients with HIV+ was not appropriate . Scores of most them were above of cut of point of questionnaires .T test was done . worse scores were Assigned to anxiety and weakness in social functions . In the other hand , life skills have been effective significantly only in social functions of women . Scores of research’s participants in anxiety , depression and total test score were enhanced , but have not been significant . In the main of article , researchers have discussed why life skills training does not have much effect on some emotional problems .Despite the fact that life skills training had a positive effect on these spouses, but due to the stress of women with AIDS spouses, life skills training did not show much effectiveness, and for outstanding effects, there is a need for individual psychological treatments and broader social support.

Keywords: Hiv, aids, social suport, life skills

Procedia PDF Downloads 47
11237 Comparative Study of Accuracy of Land Cover/Land Use Mapping Using Medium Resolution Satellite Imagery: A Case Study

Authors: M. C. Paliwal, A. K. Jain, S. K. Katiyar

Abstract:

Classification of satellite imagery is very important for the assessment of its accuracy. In order to determine the accuracy of the classified image, usually the assumed-true data are derived from ground truth data using Global Positioning System. The data collected from satellite imagery and ground truth data is then compared to find out the accuracy of data and error matrices are prepared. Overall and individual accuracies are calculated using different methods. The study illustrates advanced classification and accuracy assessment of land use/land cover mapping using satellite imagery. IRS-1C-LISS IV data were used for classification of satellite imagery. The satellite image was classified using the software in fourteen classes namely water bodies, agricultural fields, forest land, urban settlement, barren land and unclassified area etc. Classification of satellite imagery and calculation of accuracy was done by using ERDAS-Imagine software to find out the best method. This study is based on the data collected for Bhopal city boundaries of Madhya Pradesh State of India.

Keywords: resolution, accuracy assessment, land use mapping, satellite imagery, ground truth data, error matrices

Procedia PDF Downloads 490
11236 Energy and Carbon Footprint Analysis of Food Waste Treatment Alternatives for Hong Kong

Authors: Asad Iqbal, Feixiang Zan, Xiaoming Liu, Guang-Hao Chen

Abstract:

Water, food, and energy nexus is a vital subject to achieve sustainable development goals worldwide. Wastewater (WW) and food waste (FW) from municipal sources are primary contributors to their respective wastage sum from a country. Along with the loss of these invaluable natural resources, their treatment systems also consume a lot of abiotic energy and resources input with a perceptible contribution to global warming. Hence, the global paradigm has evolved from simple pollution mitigation to a resource recovery system (RRS). In this study, the prospects of six alternative FW treatment scenarios are quantitatively evaluated for Hong Kong in terms of energy use and greenhouse emissions (GHEs) potential, using life cycle assessment (LCA). Considered scenarios included: aerobic composting, anaerobic digestion (AD), combine AD and composting (ADC), co-disposal, and treatment with wastewater (CoD-WW), incineration, and conventional landfilling as base-case. Results revealed that in terms of GHEs saving, all-new scenarios performed significantly better than conventional landfilling, with ADC scenario as best-case and incineration, AD alone, CoD-WW ranked as second, third, and fourth best respectively. Whereas, composting was the worst-case scenario in terms of energy balance, while incineration ranked best and AD alone, ADC, and CoD-WW ranked as second, third, and fourth best, respectively. However, these results are highly sensitive to boundary settings, e.g., the inclusion of the impact of biogenic carbon emissions and waste collection and transportation, and several other influential parameters. The study provides valuable insights and policy guidelines for the decision-makers locally and a generic modelling template for environmental impact assessment.

Keywords: food waste, resource recovery, greenhouse emissions, energy balance

Procedia PDF Downloads 94
11235 Stress Recovery and Durability Prediction of a Vehicular Structure with Random Road Dynamic Simulation

Authors: Jia-Shiun Chen, Quoc-Viet Huynh

Abstract:

This work develops a flexible-body dynamic model of an all-terrain vehicle (ATV), capable of recovering dynamic stresses while the ATV travels on random bumpy roads. The fatigue life of components is forecasted as well. While considering the interaction between dynamic forces and structure deformation, the proposed model achieves a highly accurate structure stress prediction and fatigue life prediction. During the simulation, stress time history of the ATV structure is retrieved for life prediction. Finally, the hot sports of the ATV frame are located, and the frame life for combined road conditions is forecasted, i.e. 25833.6 hr. If the usage of vehicle is eight hours daily, the total vehicle frame life is 8.847 years. Moreover, the reaction force and deformation due to the dynamic motion can be described more accurately by using flexible body dynamics than by using rigid-body dynamics. Based on recommendations made in the product design stage before mass production, the proposed model can significantly lower development and testing costs.

Keywords: flexible-body dynamics, veicle, dynamics, fatigue, durability

Procedia PDF Downloads 374
11234 Extent to Which Various Academic Factors Cause Stress in Undergraduate Students at a University in Karachi and What Unhealthy Coping Strategies They Use

Authors: Sumara Khanzada

Abstract:

This research investigated how much stress is induced by various study-related factors, in undergraduate students belonging to a renowned university in Karachi along with the unhealthy coping strategy the students use to manage the stress. The study related factors considered for the purpose of the study were curriculum and instruction based stress, teacher-student relationship, assessment system and different components related to academic work. A survey in which questionnaires were administered to hundred students was conducted. The data were analyzed quantitatively to determine the percentages of stress induced by the various factors. The study found that student-teacher relationship is the strongest factor that causes stress in the undergraduate students specifically when teachers do not deliver the lectures effectively and give assignments and presentations to students without clear guidelines and instructions. The second important factor that causes stress was the different components of academic life, such as, parental expectations and pressures to achieve one's goals. Assessment system was found to be the third key factor inducing stress and affecting students' cognitive and psychological functioning. The most commonly used unhealthy coping strategy for stress management was procrastination. In light of the findings, it is recommended that importance be given to teacher training to ensure that instruction is proper and healthy teacher student relationship exists. Effective support programs, workshops, seminars, and different awareness programs should be arranged for promoting awareness regarding mental health in educational institutions. Moreover, additional zero credit courses should be offered to teach students how to learn stress management and healthy coping skills. Sumara Khanzada Clinical Psychologist [email protected]

Keywords: Stress, coping stretigies, acadamic stress, relationship

Procedia PDF Downloads 59
11233 Material Choice Driving Sustainability of 3D Printing

Authors: Jeremy Faludi, Zhongyin Hu, Shahd Alrashed, Christopher Braunholz, Suneesh Kaul, Leulekal Kassaye

Abstract:

Environmental impacts of six 3D printers using various materials were compared to determine if material choice drove sustainability, or if other factors such as machine type, machine size, or machine utilization dominate. Cradle-to-grave life-cycle assessments were performed, comparing a commercial-scale FDM machine printing in ABS plastic, a desktop FDM machine printing in ABS, a desktop FDM machine printing in PET and PLA plastics, a polyjet machine printing in its proprietary polymer, an SLA machine printing in its polymer, and an inkjet machine hacked to print in salt and dextrose. All scenarios were scored using ReCiPe Endpoint H methodology to combine multiple impact categories, comparing environmental impacts per part made for several scenarios per machine. Results showed that most printers’ ecological impacts were dominated by electricity use, not materials, and the changes in electricity use due to different plastics was not significant compared to variation from one machine to another. Variation in machine idle time determined impacts per part most strongly. However, material impacts were quite important for the inkjet printer hacked to print in salt: In its optimal scenario, it had up to 1/38th the impacts coreper part as the worst-performing machine in the same scenario. If salt parts were infused with epoxy to make them more physically robust, then much of this advantage disappeared, and material impacts actually dominated or equaled electricity use. Future studies should also measure DMLS and SLS processes / materials.

Keywords: 3D printing, additive manufacturing, sustainability, life-cycle assessment, design for environment

Procedia PDF Downloads 471
11232 Risk Based Inspection and Proactive Maintenance for Civil and Structural Assets in Oil and Gas Plants

Authors: Mohammad Nazri Mustafa, Sh Norliza Sy Salim, Pedram Hatami Abdullah

Abstract:

Civil and structural assets normally have an average of more than 30 years of design life. Adding to this advantage, the assets are normally subjected to slow degradation process. Due to the fact that repair and strengthening work for these assets are normally not dependent on plant shut down, the maintenance and integrity restoration of these assets are mostly done based on “as required” and “run to failure” basis. However unlike other industries, the exposure in oil and gas environment is harsher as the result of corrosive soil and groundwater, chemical spill, frequent wetting and drying, icing and de-icing, steam and heat, etc. Due to this type of exposure and the increasing level of structural defects and rectification in line with the increasing age of plants, assets integrity assessment requires a more defined scope and procedures that needs to be based on risk and assets criticality. This leads to the establishment of risk based inspection and proactive maintenance procedure for civil and structural assets. To date there is hardly any procedure and guideline as far as integrity assessment and systematic inspection and maintenance of civil and structural assets (onshore) are concerned. Group Technical Solutions has developed a procedure and guideline that takes into consideration credible failure scenario, assets risk and criticality from process safety and structural engineering perspective, structural importance, modeling and analysis among others. Detailed inspection that includes destructive and non-destructive tests (DT & NDT) and structural monitoring is also being performed to quantify defects, assess severity and impact on integrity as well as identify the timeline for integrity restoration. Each defect and its credible failure scenario is assessed against the risk on people, environment, reputation and production loss. This technical paper is intended to share on the established procedure and guideline and their execution in oil & gas plants. In line with the overall roadmap, the procedure and guideline will form part of specialized solutions to increase production and to meet the “Operational Excellence” target while extending service life of civil and structural assets. As the result of implementation, the management of civil and structural assets is now more systematically done and the “fire-fighting” mode of maintenance is being gradually phased out and replaced by a proactive and preventive approach. This technical paper will also set the criteria and pose the challenge to the industry for innovative repair and strengthening methods for civil & structural assets in oil & gas environment, in line with safety, constructability and continuous modification and revamp of plant facilities to meet production demand.

Keywords: assets criticality, credible failure scenario, proactive and preventive maintenance, risk based inspection

Procedia PDF Downloads 381
11231 Cardiac Rehabilitation Program and Health-Related Quality of Life; A Randomized Control Trial

Authors: Zia Ul Haq, Saleem Muhammad, Naeem Ullah, Abbas Shah, Abdullah Shah

Abstract:

Pakistan being the developing country is facing double burden of communicable and non-communicable disease. The aspect of secondary prevention of ischemic heart disease in developing countries is the dire need for public health specialists, clinicians and policy makers. There is some evidence that psychotherapeutic measures, including psychotherapy, recreation, exercise and stress management training have positive impact on secondary prevention of cardiovascular diseases but there are some contradictory findings as well. Cardiac rehabilitation program (CRP) has not yet fully implemented in Pakistan. Psychological, physical and specific health-related quality of life (HRQoL) outcomes needs assessment with respect to its practicality, effectiveness, and success. Objectives: To determine the effect of cardiac rehabilitation program (CRP) on the health-related quality of life (HRQoL) measures of post MI patients compared to the usual care. Hypothesis: Post MI patients who receive the interventions (CRP) will have better HRQoL as compared to those who receive the usual cares. Methods: The randomized control trial was conducted at a Cardiac Rehabilitation Unit of Lady Reading Hospital (LRH), Peshawar. LRH is the biggest hospital of the Province Khyber Pakhtunkhwa (KP). A total 206 participants who had recent first myocardial infarction were inducted in the study. Participants were randomly allocated into two group i.e. usual care group (UCG) and cardiac rehabilitation group (CRG) by permuted-block randomization (PBR) method. CRP was conducted in CRG in two phases. Three HRQoL outcomes i.e. general health questionnaire (GHQ), self-rated health (SRH) and MacNew quality of life after myocardial infarction (MacNew QLMI) were assessed at baseline and follow-up visits among both groups. Data were entered and analyzed by appropriate statistical test in STATA version 12. Results: A total of 195 participants were assessed at the follow-up period due to lost-to-follow-up. The mean age of the participants was 53.66 + 8.3 years. Males were dominant in both groups i.e. 150 (76.92%). Regarding educational status, majority of the participants were illiterate in both groups i.e. 128 (65.64%). Surprisingly, there were 139 (71.28%) who were non-smoker on the whole. The comorbid status was positive in 120 (61.54%) among all the patients. The SRH at follow-up among UCG and CRG was 4.06 (95% CI: 3.93, 4.19) and 2.36 (95% CI: 2.2, 2.52) respectively (p<0.001). GHQ at the follow-up of UCG and CRG was 20.91 (95% CI: 18.83, 21.97) and 7.43 (95% CI: 6.59, 8.27) respectively (p<0.001). The MacNew QLMI at follow-up of UCG and CRG was 3.82 (95% CI: 3.7, 3.94) and 5.62 (95% CI: 5.5, 5.74) respectively (p<0.001). All the HRQoL measures showed strongly significant improvement in the CRG at follow-up period. Conclusion: HRQOL improved in post MI patients after comprehensive CRP. Education of the patients and their supervision is needed when they are involved in their rehabilitation activities. It is concluded that establishing CRP in cardiac units, recruiting post-discharged MI patients and offering them CRP does not impose high costs and can result in significant improvement in HRQoL measures. Trial registration no: ACTRN12617000832370

Keywords: cardiovascular diseases, cardiac rehabilitation, health-related quality of life, HRQoL, myocardial infarction, quality of life, QoL, rehabilitation, randomized control trial

Procedia PDF Downloads 210
11230 Effects of Nutrients Supply on Milk Yield, Composition and Enteric Methane Gas Emissions from Smallholder Dairy Farms in Rwanda

Authors: Jean De Dieu Ayabagabo, Paul A.Onjoro, Karubiu P. Migwi, Marie C. Dusingize

Abstract:

This study investigated the effects of feed on milk yield and quality through feed monitoring and quality assessment, and the consequent enteric methane gas emissions from smallholder dairy farms in drier areas of Rwanda, using the Tier II approach for four seasons in three zones, namely; Mayaga and peripheral Bugesera (MPB), Eastern Savanna and Central Bugesera (ESCB), and Eastern plateau (EP). The study was carried out using 186 dairy cows with a mean live weight of 292 Kg in three communal cowsheds. The milk quality analysis was carried out on 418 samples. Methane emission was estimated using prediction equations. Data collected were subjected to ANOVA. The dry matter intake was lower (p<0.05) in the long dry season (7.24 Kg), with the ESCB zone having the highest value of 9.10 Kg, explained by the practice of crop-livestock integration agriculture in that zone. The Dry matter digestibility varied between seasons and zones, ranging from 52.5 to 56.4% for seasons and from 51.9 to 57.5% for zones. The daily protein supply was higher (p<0.05) in the long rain season with 969 g. The mean daily milk production of lactating cows was 5.6 L with a lower value (p<0.05) during the long dry season (4.76 L), and the MPB zone having the lowest value of 4.65 L. The yearly milk production per cow was 1179 L. The milk fat varied from 3.79 to 5.49% with a seasonal and zone variation. No variation was observed with milk protein. The seasonal daily methane emission varied from 150 g for the long dry season to 174 g for the long rain season (p<0.05). The rain season had the highest methane emission as it is associated with high forage intake. The mean emission factor was 59.4 Kg of methane/year. The present EFs were higher than the default IPPC value of 41 Kg from developing countries in African, the Middle East, and other tropical regions livestock EFs using Tier I approach due to the higher live weight in the current study. The methane emission per unit of milk production was lower in the EP zone (46.8 g/L) due to the feed efficiency observed in that zone. Farmers should use high-quality feeds to increase the milk yield and reduce the methane gas produced per unit of milk. For an accurate assessment of the methane produced from dairy farms, there is a need for the use of the Life Cycle Assessment approach that considers all the sources of emissions.

Keywords: footprint, forage, girinka, tier

Procedia PDF Downloads 185
11229 Preliminary Seismic Vulnerability Assessment of Existing Historic Masonry Building in Pristina, Kosovo

Authors: Florim Grajcevci, Flamur Grajcevci, Fatos Tahiri, Hamdi Kurteshi

Abstract:

The territory of Kosova is actually included in one of the most seismic-prone regions in Europe. Therefore, the earthquakes are not so rare in Kosova; and when they occurred, the consequences have been rather destructive. The importance of assessing the seismic resistance of existing masonry structures has drawn strong and growing interest in the recent years. Engineering included those of Vulnerability, Loss of Buildings and Risk assessment, are also of a particular interest. This is due to the fact that this rapidly developing field is related to great impact of earthquakes on the socioeconomic life in seismic-prone areas, as Kosova and Prishtina are, too. Such work paper for Prishtina city may serve as a real basis for possible interventions in historic buildings as are museums, mosques, old residential buildings, in order to adequately strengthen and/or repair them, by reducing the seismic risk within acceptable limits. The procedures of the vulnerability assessment of building structures have concentrated on structural system, capacity, and the shape of layout and response parameters. These parameters will provide expected performance of the very important existing building structures on the vulnerability and the overall behavior during the earthquake excitations. The structural systems of existing historical buildings in Pristina, Kosovo, are dominantly unreinforced brick or stone masonry with very high risk potential from the expected earthquakes in the region. Therefore, statistical analysis based on the observed damage-deformation, cracks, deflections and critical building elements, would provide more reliable and accurate results for the regional assessments. The analytical technique was used to develop a preliminary evaluation methodology for assessing seismic vulnerability of the respective structures. One of the main objectives is also to identify the buildings that are highly vulnerable to damage caused from inadequate seismic performance-response. Hence, the damage scores obtained from the derived vulnerability functions will be used to categorize the evaluated buildings as “stabile”, “intermediate”, and “unstable”. The vulnerability functions are generated based on the basic damage inducing parameters, namely number of stories (S), lateral stiffness (LS), capacity curve of total building structure (CCBS), interstory drift (IS) and overhang ratio (OR).

Keywords: vulnerability, ductility, seismic microzone, ductility, energy efficiency

Procedia PDF Downloads 387
11228 Prevalence of Malocclusion and Assessment of Orthodontic Treatment Needs in Malay Transfusion-Dependent Thalassemia Patients

Authors: Mohamed H. Kosba, Heba A. Ibrahim, H. Rozita

Abstract:

Statement of the Problem: The life expectancy for transfusion-dependent thalassemia patients has increased dramatically with iron-chelation therapy and other modern management modalities. In these patients, the most dominant maxillofacial manifestations are protrusion of zygomatic bones and premaxilla due to the hyperplasia of bone marrow. The purpose of this study is to determine the prevalence of malocclusion and orthodontic treatment needs according to the Dental Aesthetic Index (DAI) among Malay transfusion-dependent thalassemia patients. Orientation: This is a cross-sectional study consist of 43 Malay transfusion-dependent thalassemia patients, 22 males, and 19 females with the mean age of 15.9 years old (SD 3.58). The subjects were selected randomly from patients attending Paediatrics and Internal Medicine Clinic at Hospital USM and Hospital Sultana Bahiyah. The subjects were assessed for malocclusion according to Angle’s classification, and orthodontic treatment needs using DAI. The results show that 22 of the subjects (51.1%) have class II malocclusion, 12 subjects (28%) have class І, while 9 subjects (20.9%) have class Ⅲ. The assessment of orthodontic treatment needs to reveal 22 cases (51.1%) fall in the normal/minor needs category, 12 subjects (28%) fall in the severe and very severe category, while 9 subjects (20.9%) fall in the definite category. Conclusion & Significance: Half of Malay transfusion-dependent thalassemia patients have Class Ⅱmalocclusion. About 28% had malocclusion and required orthodontic treatment. This research shows that Malay transfusion-dependent thalassemia may require orthodontic management; earlier intervention to reduce the complexity of the treatment later, suggesting functional appliance as a suitable treatment option for them, a twin block appliance together with headgear to restrict maxillary growth suggested for management. The current protocol implemented by the Malaysian Ministry of Health for the management of these patients seems to be sufficient since the result shows that about 28% require orthodontic treatment need, according to DAI.

Keywords: prevalence, DAI, thalassaemia, angle classification

Procedia PDF Downloads 125
11227 Inhibition Theory: The Development of Subjective Happiness and Life Satisfaction After Experiencing Severe Traumatic Life Events (Paraplegia)

Authors: Tanja Ecken, Laura Fricke, Anika Wehling, Maren M. Michaelsen, Tobias Esch

Abstract:

Studies and applied experiences evidence severe and traumatic accidents not only require physical rehabilitation and recovery but also necessitate a psychological adaption and reorganization to the changed living conditions. Neurobiological models underpinning the experience of happiness and satisfaction postulate life shocks to potentially enhance the experience of happiness and life satisfaction, i.e., posttraumatic growth (PTG). This present study aims to provide an in-depth understanding of the underlying psychological processes of PTG and to outline its consequences on subjective happiness and life satisfaction. To explore the aforementioned, Esch’s ABC Model was used as guidance for the development of a questionnaire assessing changes in happiness and life satisfaction and for a schematic model postulating the development of PTG in the context of paraplegia. Two-stage qualitative interview procedures explored participants’ experiences of paraplegia. Specifically, narrative, semi-structured interviews (N=28) focused on the time before and after the accident, the availability of supportive resources, and potential changes in the perception of happiness and life satisfaction. Qualitative analysis (Grounded Theory) indicated an initial phase of reorganization was followed by a gradual psychological adaption to novel, albeit reduced, opportunities in life. Participants reportedly experienced a ‘compelled’ slowing down and elements of mindfulness, subsequently instilling a sense of gratitude and joy in relation to life’s presumed trivialities. Despite physical limitations and difficulties, participants reported an enhanced ability to relate to oneself and others and a reduction of perceived everyday nuisances. Concluding, PTG can be experienced in response to severe, traumatic life events and has the potential to enrich the lives of affected persons in numerous, unexpected and yet challenging ways. PTG appears to be a spectrum comprised of an interplay of internal and external resources underpinned by neurobiological processes. Participants experienced PTG irrelevant of age, gender, marital status, income or level of education.

Keywords: post traumatic growth, happiness, life satisfaction, traumatic life events, paraplegia, ABC model, trauma

Procedia PDF Downloads 50
11226 Applying Swanson's Theory of Caring to Manage Multiple Trauma Patient

Authors: Hsin-Yi Lo, Chia-Yu Hsu

Abstract:

This article is the nursing experience of a multiple trauma case using Swanson's theory of caring, the nursing period is from May 31 to June 4, 2021, collect data through observation, written talks, interviews, listening, direct care and physical assessment, established cases with health problems such as acute pain, impaired tissue integrity, and anxiety. Nursing process including, evaluate the pain index with the pain assessment scale, assist in acupoint massage, use a corset to fix the wound, and give the patient listening to favorite radio programs to divert attention and relieve pain problems; promote wound healing and avoid infection by assessing wound condition and exudation, changing dressings with aseptic technique, and providing appropriate dressings; encourage patients to express their feelings, provide companionship, and assist in self-care and participation in treatment plans, to enable the case to overcome the anxiety caused by being admitted to the intensive care unit for the first time and not knowing about the disease, and assist the case to overcome the injury caused by the accident and return to normal life. There is no video equipment in the intensive care unit during the nursing period. In response to the problem that family visits cannot be opened during the epidemic, it is a limitation this time. It is recommended that the hospital take this into consideration in the future. In the post-epidemic era, it can reduce the risk of various infections for patients and family members. Traveling between home and hospital, improving the quality of high-quality and technological care.

Keywords: swanson's theory of caring, multiple trauma, anxiety, nursing experience

Procedia PDF Downloads 60
11225 “It Just Feels Risky”: Intuition vs Evidence in Child Sexual Abuse Cases. Proposing an Empirically Derived Risk and Protection Protocol

Authors: Christian Perrin, Nicholas Blagden, Louise Allen, Sarah Impey

Abstract:

Social workers in the UK and professionals globally are faced with a particular challenge when dealing with allegations of child sexual abuse (CSA) in the community. In the absence of a conviction or incontestable evidence, staff can often find themselves unable to take decisive action to remove a child from harm, even though there may be a credible threat to their welfare. Conversely, practitioners may over-calculate risk through fear of being accountable for harm. This is, in part, due to the absence of a structured and evidence-based risk assessment tool which can predict the likelihood of a person committing child sexual abuse. Such assessments are often conducted by forensic professionals who utilise offence-specific data and personal history information to calculate risk. In situations where only allegations underpin a case, this mode of assessment is not viable. There are further ethical issues surrounding the assessment of risk in this area which require expert consideration and sensitive planning. This paper explores this entangled problem extant in the wider call to prevent sexual and child sexual abuse in the community. To this end, 32 qualitative interviews were undertaken with social workers dealing with CSA cases. Results were analysed using thematic analysis and operationalised to formulate a risk and protection protocol for use in case management. This paper reports on the early findings associated with the initial indications of protocol reliability. Implications for further research and practice are discussed.

Keywords: sexual offending, child sexual offence, offender rehabilitation, risk assessment, offence prevention

Procedia PDF Downloads 94
11224 Reviewing Performance Assessment Frameworks for Urban Sanitation Services in India

Authors: Gaurav Vaidya, N. R. Mandal

Abstract:

UN Summit, 2000 had resolved to provide access to sanitation to whole humanity as part of ‘Millennium Development Goals -2015’. However, more than one third of world’s population still did not have the access to basic sanitation facilities by 2015. Therefore, it will be a gigantic challenge to achieve goal-6 of ‘UN Sustainable Development Goal’ to ensure availability and sustainable management of sanitation for all by the year 2030. Countries attempt to find out own ways of meeting this challenge of providing access to safe sanitation and as part of monitoring the actions have prepared varied types of ‘performance assessment frameworks (PAF)’. India introduced Service Level Benchmarking (SLB) in 2010 to set targets and achieve the goals of NUSP. Further, a method of reviewing performance was introduced as ‘Swachh Sarvekshan’ (Cleanliness Surveys) in 2016 and in 2017 guidelines for the same was revised. This study, as a first step, reviews the documents in use in India with a conclusion that the frameworks adopted are based on target setting, financial allocation and performance in achieving the targets set. However, it does not focus upon sanitation needs holistically i.e., areas and aspects not targeted through projects are not covered in the performance assessment. In this context, as a second step, this study reviews literature available on performance assessment frameworks for urban sanitation in selected other countries and compares the same with that in India. The outcome of the comparative review resulted in identification of unaddressed aspects as well as inadequacy of parameters in Indian context. Thirdly, in an attempt to restructure the performance assessment process and develop an index in urban sanitation, researches done in other urban services such as health and education were studied focusing on methods of measuring under-performance. As a fourth step, a tentative modified framework is suggested with the help of understanding drawn from above for urban sanitation using stages of Urban Sanitation Service Chain Management (SSCM) and modified set of parameters drawn from the literature review in the first and second steps. This paper reviews existing literature on SSCM procedures, Performance Index in sanitation and other urban services and identifies a tentative list of parameters and a framework for measuring under-performance in sanitation services. This may aid in preparation of a Service Delivery Under-performance Index (SDUI) in future.

Keywords: assessment, performance, sanitation, services

Procedia PDF Downloads 132
11223 Fuzzy Logic in Detecting Children with Behavioral Disorders

Authors: David G. Maxinez, Andrés Ferreyra Ramírez, Liliana Castillo Sánchez, Nancy Adán Mendoza, Carlos Aviles Cruz

Abstract:

This research describes the use of fuzzy logic in detection, assessment, analysis and evaluation of children with behavioral disorders. It shows how to acquire and analyze ambiguous, vague and full of uncertainty data coming from the input variables to get an accurate assessment result for each of the typologies presented by children with behavior problems. Behavior disorders analyzed in this paper are: hyperactivity (H), attention deficit with hyperactivity (DAH), conduct disorder (TD) and attention deficit (AD).

Keywords: alteration, behavior, centroid, detection, disorders, economic, fuzzy logic, hyperactivity, impulsivity, social

Procedia PDF Downloads 541
11222 Development of Risk-Based Ambient Air Quality Standards in the Russian Federation on the Basis of Risk Assessment Procedures Harmonized with International Approaches

Authors: Nina V. Zaitseva, Pavel Z. Shur, Nina G. Atiskova

Abstract:

Nowadays harmonization of sanitary and hygienic standards of environmental quality with international standards is crucial part of integration of Russia into the international community. Harmonization of Russian and international ambient air quality standards may be realized by risk-based standards development. In this paper approaches to risk-based standards development and examples of these approaches implementation are presented.

Keywords: harmonization, health risk assessment, evolutionary modelling, benchmark level, nickel, manganese

Procedia PDF Downloads 371
11221 Comprehensive Geriatric Assessments: An Audit into Assessing and Improving Uptake on Geriatric Wards at King’s College Hospital, London

Authors: Michael Adebayo, Saheed Lawal

Abstract:

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

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

Procedia PDF Downloads 68
11220 Financial Assessment of the Hard Coal Mining in the Chosen Region in the Czech Republic: Real Options Methodology Application

Authors: Miroslav Čulík, Petr Gurný

Abstract:

This paper is aimed at the financial assessment of the hard coal mining in a given region by real option methodology application. Hard coal mining in this mine makes net loss for the owner during the last years due to the long-term unfavourable mining conditions and significant drop in the coal prices during the last years. Management is going to shut down the operation and abandon the project to reduce the loss of the company. The goal is to assess whether the shutting down the operation is the only and correct solution of the problem. Due to the uncertainty in the future hard coal price evolution, the production might be again restarted if the price raises enough to cover the cost of the production. For the assessment, real option methodology is applied, which captures two important aspect of the financial decision-making: risk and flexibility. The paper is structured as follows: first, current state is described and problem is analysed. Next, methodology of real options is described. At last, project is evaluated by applying real option methodology. The results are commented and recommendations are provided.

Keywords: real option, investment, option to abandon, option to shut down and restart, risk, flexibility

Procedia PDF Downloads 531
11219 Evaluation of Environmental Impact Assessment of Dam Using GIS/Remote Sensing-Review

Authors: Ntungamili Kenosi, Moatlhodi W. Letshwenyo

Abstract:

Negative environmental impacts due to construction of large projects such as dams have become an important aspect of land degradation. This paper will review the previous literature on the previous researches or study in the same area of study in the other parts of the world. After dam has been constructed, the actual environmental impacts are investigated and compared to the predicted results of the carried out Environmental Impact Assessment. GIS and Remote Sensing, play an important role in generating automated spatial data sets and in establishing spatial relationships. Results from other sources shows that the normalized vegetation index (NDVI) analysis was used to detect the spatial and temporal change of vegetation biomass in the study area. The result indicated that the natural vegetation biomass is declining. This is mainly due to the expansion of agricultural land and escalating human made structures in the area. Urgent environmental conservation is necessary when adjoining projects site. Less study on the evaluation of EIA on dam has been conducted in Botswana hence there is a need for the same study to be conducted and then it will be easy to be compared to other studies around the world.

Keywords: Botswana, dam, environmental impact assessment, GIS, normalized vegetation index (NDVI), remote sensing

Procedia PDF Downloads 390
11218 Assessment of Sleep Disorders in Moroccan Women with Gynecological Cancer: Cross-Sectional Study

Authors: Amina Aquil, Abdeljalil El Got

Abstract:

Background: Sleep quality is one of the most important indicators related to the quality of life of patients suffering from cancer. Many factors could affect this quality of sleep and then be considered as associated predictors. Methods: The aim of this study was to assess the prevalence of sleep disorders and the associated factors with impaired sleep quality in Moroccan women with gynecological cancer. A cross-sectional study was carried out within the oncology department of the Ibn Rochd University Hospital, Casablanca, on Moroccan women who had undergone radical surgery for gynecological cancer (n=100). Translated and validated Arabic versions of the following international scales were used: Pittsburgh sleep quality index (PSQI), Hospital Anxiety and Depression Scale (HADS), Rosenberg's self-esteem scale (RSES), and Body image scale (BIS). Results: 78% of participants were considered poor sleepers. Most of the patients exhibited very poor subjective quality, low sleep latency, a short period of sleep, and a low rate of usual sleep efficiency. The vast majority of these patients were in poor shape during the day and did not use sleep medication. Waking up in the middle of the night or early in the morning and getting up to use the bathroom were the main reasons for poor sleep quality. PSQI scores were positively correlated with anxiety, depression, body image dissatisfaction, and lower self-esteem (p < 0.001). Conclusion: Sleep quality and its predictors require a systematic evaluation and adequate management to prevent sleep disturbances and mental distress as well as to improve the quality of life of these patients.

Keywords: body image, gynecological cancer, self esteem, sleep quality

Procedia PDF Downloads 105