Search results for: complex shaped part

Authors: Hassan Wajid, Syed T. Ahmed, Syed G. Haider Jr., Razia Latif, Ahsan Ali, Maira Anam

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The phenomenon of Metamorphosis can be associated with any object, organism, or structure gradually and progressively going through the change of systemic or morphological form. This phenomenon can be integrated while teaching drawing to architecture students. In architectural drawings, metamorphosis’s main focus and purpose are not to completely imitate any object. In the process of drawing, the changes in systemic or morphological form happen until the complete process, and the visuals of the complete process change the drawing, opening up possibilities for the imagination of the perceivers. Metamorphosis in architectural drawings begins with an initial form and, through various noticeable stages, ends up final form or manifestation. How much of the initial form is manifested in the final form and progressively among various intermediate stages becomes an indication of the nature of metamorphosis as a phenomenon. It is important at this stage to clarify that the term metamorphosis is presently being coopted from its original domain, usually in life sciences. In this current exercise, the architectural drawings are to act as an operative analog process transforming one image of art and/or architecture in its broadest sense. That composition is claimed to have come from one source (individual work, a cultural artifact, civilizational remain). It dialectically meets, opposes, or confronts some carefully chosen alien opposites from a different domain. As an example, the layers of a detailed drawing of a Turkish prayer rug of 5 x 7 ratio over a detailed architectural plan of a religious, historical complex can be observed such that the two drawings, though at markedly different scales could dialectically converse with one another and through their mutual congruencies. In the final stage, the idea concludes contradictions across the scales to initiate the analogous roles of metamorphosed third reality, which suggests the previous un-acknowledged architectural or artistic identity. The proposed paper explores the trajectory of reproduction by analyzing drawings through detailed drawing stages and analyzes challenges as well as opportunities in the discovered realm of imagination. This description further aims at identifying factors influencing creativity and innovation in producing architectural drawings through the process of observing drawings from inception to the concluding stage.

Keywords: architectural drawings, metamorphosis, perceptions, discovery

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Authors: K. P. Valdés García, E. I. Rodríguez Fonseca, L. G. Juárez Cantú

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Suicide is a global, multidimensional and dynamic problem of mental health, which requires a constant study for its understanding and prevention. When research of this phenomenon is done, it is necessary to consider the different characteristics it may have because of the individual and sociocultural variables, the importance of this consideration is related to the generation of effective treatments and interventions. Adolescents are a vulnerable population due to the characteristics of the development stage. The investigation was carried out with the objective of identifying and describing the conceptualization of adolescents of suicide, and in this process, we find possible differences between men and women. The study was carried out in Saltillo, Coahuila, Mexico. The sample was composed of 418 volunteer students aged between 11 and 18 years. The ethical aspects of the research were reviewed and considered in all the processes of the investigation with the participants, their parents and the schools to which they belonged, psychological attention was offered to the participants and preventive workshops were carried in the educational institutions. Natural semantic networks were the instrument used, since this hybrid method allows to find and analyze the social concept of a phenomenon; in this case, the word suicide was used as an evocative stimulus and participants were asked to evoke at least five words and a maximum 10 that they thought were related to suicide, and then hierarchize them according to the closeness with the construct. The subsequent analysis was carried with Excel, yielding the semantic weights, affective loads and the distances between each of the semantic fields established according to the words reported by the subjects. The results showed similarities in the conceptualization of suicide in adolescents, men and women. Seven semantic fields were generated; the words were related in the discourse analysis: 1) death, 2) possible triggering factors, 3) associated moods, 4) methods used to carry it out, 5) psychological symptomatology that could affect, 6) words associated with a rejection of suicide, and finally, 7) specific objects to carry it out. One of the necessary aspects to consider in the investigations of complex issues such as suicide is to have a diversity of instruments and techniques that adjust to the characteristics of the population and that allow to understand the phenomena from the social constructs and not only theoretical. The constant study of suicide is a pressing need, the loss of a life from emotional difficulties that can be solved through psychiatry and psychological methods requires governments and professionals to pay attention and work with the risk population.

Keywords: adolescents, psychological construct, semantic networks, suicide

Procedia PDF Downloads 109

Authors: Cholpassorn Sitthiwarongchai, Chutikarn Sriviboon

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The two primary objectives of this research were (1) to examine the current knowledge and actual circumstance of agricultural workers about mangosteen product processing; and (2) to analyze and evaluate ways to develop capacity of mangosteen product processing. The population of this study was 15,125 people who work in the agricultural sector, in this context, mangosteen production, in the eastern part of Thailand that included Chantaburi Province, Rayong Province, Trad Province and Pracheenburi Province. The sample size based on Yamane’s calculation with 95% reliability was therefore 392 samples. Mixed method was employed included questionnaire and focus group discussion with Connoisseurship Model used in order to collect quantitative and qualitative data. Key informants were used in the focus group including agricultural business owners, academic people in agro food processing, local academics, local community development staff, OTOP subcommittee, and representatives of agro processing industry professional organizations. The study found that the majority of the respondents agreed with a high level (in five-rating scale) towards most of variables of knowledge management in agro food processing. The result of the current knowledge and actual circumstance of agricultural human resource in an arena of mangosteen product processing revealed that mostly, the respondents agreed at a high level to establish 7 variables. The guideline to developing the body of knowledge in order to enhance the capacity of the agricultural workers in mangosteen product processing was delivered in the focus group discussion. The discussion finally contributed to an idea to produce manuals for mangosteen product processing methods, with 4 products chosen: (1) mangosteen soap, (2) mangosteen juice, (3) mangosteen toffee, and (4) mangosteen preserves or jam.

Keywords: capacity enhancement, agricultural workers, mangosteen product processing, marketing management

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Authors: Pirjo Kaakinen, Helvi Kyngäs, Danica Železnik

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People live longer than earlier and healthy lifestyle is one of the important issue to prevent functional inability and chronic disease. Aim of this study was describe the lifestyle changes of Carintia region’s people. The study was cross-sectional study. Data were collected by questionnaire in two period, first May 2013 (N=63) and on March 2014 (N=77) at the University of College of ‘Health Sciences Slovenj Gradec’. The study was part of project ‘Choose a healthy lifestyle - an investment for the future’. The questionnaire included self-estimated questions about physical activity, nutrition, grocery habit, smoking habit and alcohol use. Participants were measured clinical parameters such as blood pressure, blood glucose, BMI. Most of participants were women (61%) and they were over 60 years old (64%). Participants have a high BMI (75%) and elevated blood pressure (64%). However, almost all participants (89%) had normal blood glucose level. Slightly more than half of participants (54%) have normal cholesterol level. Participants (83%) eat breakfast in the morning and most of them have three or four daily meals. Fruit and vegetable consumption decrease during this study. Half of participants (51%) drank a litre of water per day and popular beverage was coffee or tea. To drink carbonate beverages was not so popular over 60 year’s old participants than younger one. There was less smokers in 2014 than 2013. Intensity of daily physical activity increased during healthy lifestyle project. The most popular form of physical activity was hiking. This study showed that the project can be effective in the Carintia region’s people lifestyle changes even it was short time. People did changes in their daily life and there were a positive influence physical activity, meal frequency, fruit, vegetable and alcohol consumption. In the future is needed the follow up study to get out longitudinal lifestyle changes.

Keywords: adults, healthy lifestyle, health education, quality of life

Procedia PDF Downloads 267

Authors: B. R. Faleye, M. I. Titocan, M. P. Ibitola

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Investigation was carried out at Opic Estate in Isheri-Osun River Basin environment using Electrical Resistivity method to study saltwater intrusion into a fresh water aquifer system from the proximal estuarine water body. The investigation is aimed at aquifer characterisation using electrical resistivity method in order to provide the depth to which fresh water fit for both domestic and industrial consumption. The 2D Electrical Resistivity and Vertical Electrical Resistivity techniques alongside Laboratory analysis of water samples obtained from the boreholes were adopted. Three traverses were investigated using Wenner and Pole-Dipole array with multi-electrode system consisting of 84 electrodes and a spread of 581 m, 664 m and 830 m were attained on the traverses. The main lithologies represented in the study area are Sand, Clay and Clayey Sand of which Sand constitutes the aquifer in the study area. Vertical Electrical Sounding data obtained at different lateral distance on the traverses have indicated that the water in the aquifer in the subsurface is brackish. Brackish water is represented by lowelectrical resistivity value signature while fresh water is characterized by relatively high electrical resistivity and in some regionfresh water is existent at depth greater than 200 m. Results of laboratory analysis of samples showed that the pH, Salinity, Total Dissolved Solid and Conductivity indicated existence of water with poor quality, indicating that salinity, TDS and Conductivity is higher in the Northern part of the study area. The 2D electrical resistivity and Vertical Electrical Sounding methods indicate that fresh water region is at ≥200m depth. Aquifers not fit for domestic use in the study area occur downwards to about 200 m in depth. In conclusion, it is recommended that wells should be sunkbeyond 220 m for the possible procurement of portable fresh water.

Keywords: 2D electrical resistivity, aquifer, brackish water, lithologies

Procedia PDF Downloads 431

Authors: Simone Huber, Bianca Schnalzer, Baptiste Alcalde, Sten Hanke, Lampros Mpaltadoros, Thanos G. Stavropoulos, Spiros Nikolopoulos, Ioannis Kompatsiaris, Lina Pérez- Breva, Vallivana Rodrigo-Casares, Jaime Fons-Martínez, Jeroen de Bruin

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Developing new medicine and health solutions and improving patient health currently rely on the successful execution of clinical trials, which generate relevant safety and efficacy data. For their success, recruitment and retention of participants are some of the most challenging aspects of protocol adherence. Main barriers include: i) lack of awareness of clinical trials; ii) long distance from the clinical site; iii) the burden on participants, including the duration and number of clinical visits and iv) high dropout rate. Most of these aspects could be addressed with a new paradigm, namely the Remote Decentralized Clinical Trials (RDCTs). Furthermore, the COVID-19 pandemic has highlighted additional advantages and challenges for RDCTs in practice, allowing participants to join trials from home and not depend on site visits, etc. Nevertheless, RDCTs should follow the process and the quality assurance of conventional clinical trials, which involve several processes. For each part of the trial, the Building Blocks, existing software and technologies were assessed through a systematic search. The technology needed to perform RDCTs is widely available and validated but is yet segmented and developed in silos, as different software solutions address different parts of the trial and at various levels. The current paper is analyzing the availability of technology to perform RDCTs, identifying gaps and providing an overview of Basic Building Blocks and functionalities that need to be covered to support the described processes.

Keywords: architectures and frameworks for health informatics systems, clinical trials, information and communications technology, remote decentralized clinical trials, technology availability

Procedia PDF Downloads 218

Authors: Charles Chijioke Dike, Hugh Clifford Chima Maduka, Chinwe A. Isibor

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Fish is among the products consumed at a very high rate. In most countries of the world, fish are used as part of the daily meal. The high cost of commercial fish feeds in Africa has made it necessary the development of an alternative source of fish feed processing from organic waste. The objective of this research is to investigate the efficacy of fish feeds processed from various animal wastes in order to know whether those feeds shall be alternatives to commercial feeds. This work shall be carried out at the Research Laboratory Unit of the Department of Human Biochemistry, Faculty of Basic Medical Sciences, College of Health Sciences, Nnamdi Azikiwe University (NAU), Nnewi Campus, Anambra State. The fingerlings to be used shall be gotten from the Agricultural Department of NAU, Awka, Anambra State, and allowed to acclimatize for 14 d. Animal and food wastes shall be gotten from Nnewi. The fish shall be grouped into 1-13 (Chicken manure only, cow dung only, pig manure only, chicken manure + yeast, cow dung + yeast, pig manure + yeast, chicken manure + other wastes + yeast, cow dung + other wastes + yeast, and pig manure + other wastes + yeast. Feed assessment shall be carried out by determining bulk density, feed water absorption, feed hardness, feed oil absorption, and feed water stability. The nutritional analysis shall be carried out on the feeds processed. The risk assessment shall be done on the fish by determining methylmercury (MeHg), polycyclic aromatic hydrocarbons (PAHs), and dichloro-diphenyl-trichloroethane (DDT) in the fish. The results from this study shall be analyzed statistically using SPSS statistical software, version 25. The hypothesis is that fish feeds processed from animal wastes are efficient in raising catfish. The outcome of this study shall provide the basis for the formulation of fish feeds from organic wastes.

Keywords: assessment, feeds, health risk, wastes

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Authors: Gizem Kodak, Birsen Koldemir

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The Turkish Straits are at the crossroads of Europe and Asia continents and are unique waterways connecting the Black Sea countries to the rest of the world. Because of the geostrategic value of the location, passage of trade and war ships through the Turkish Straits has become a vital attraction and importance for the great powers and the riparian states throughout the history. This study contains a temporal analysis of the legal measures implemented in the Turkish Straits System. In this context, the historical alternation of the Turkish Straits has been examined, taking into account the relevant national and international regulations. In other words, relevant national and international regulations have been examined in this study according to historical time schedules. Parallel to the main concept mentioned above, the first chapter focuses on international regulations. These arrangements are organized according to date order and in three subheadings: Sèvres Treaty (1920), Lausanne Treaty (1923) and Montreux Convention (1936). Another topic, the national regulations, has been examined under five subheadings. These; (1982), Port Regulations of Canakkale (1982), Marine Traffic Regulations of the Turkish Straits and Marmara Region (1994) and Maritime Traffic Regulations for the Turkish Straits (1998). In doing so, the aim was to identify the differences in legal arrangements throughout the time regarding the navigation through the Turkish Straits. The current situation of the Turkish Straits has been presented in detail in the last part of the work, taking Montreux Convention into consideration. In this context, the articles of the Convention which regulate the passage of trade vessels have been examined from two perspectives; Peace time and war time. As for the measures that can be implemented in time of war, three options put forward depending on Turkey's stance: ‘Turkey not being belligerent’, ‘Turkey being belligerent’ and ‘situation in which Turkey considers herself threatened with imminent danger of war’.

Keywords: temporal analysis, maritime law, Turkish straits, maritime accidents

Procedia PDF Downloads 153

Authors: Hesham Hamdy Abdelmohsen, Ahmed Shawky Abdul Azizb, Mona Fawzy Aldaghma

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Helical piles have earned considerable attention as an effective deep foundation alternative due to their rapid installation process and their dual purpose in compression and tension. These piles find common uses as foundations for structures like solar panels, wind turbines, offshore platforms, and some kinds of retaining walls. These structures usually transfer different combinations of loads to their helical-pile foundations in the form of axial and lateral loads. Extensive research has been conducted to investigate and understand the behavior of these piles under the influence of either axial or lateral loads. However, the impacts of loading patterns that may act on the helical piles as combinations of axial compression and lateral loads still need more efforts of research work. This paper presents the results of an experimental (Lab tests) and numerical (PLAXIS-3D) study performed on vertical helical-pile groups under the action of combined loads as axial compression (bearing loads), acting successively with lateral (horizontal) loads. The study aims to clarify the effects of key factors, like helix location and direction of lateral load, on the lateral capacity of helical-pile groups and, consequently, on group efficiency. Besides the variation of helix location and lateral load direction, three patterns of successive bearing combined loads were considered, in which the axial vertical compression load was either zero, V1 or V2, whereas the lateral horizontal loads were varied under each vertical compression load. The study concluded that the lateral capacity of the helical-pile group is significantly affected by helix location within the length of the pile shaft. The optimal lateral performance is achieved with helices at a depth ratio of H/L = 0.4. Furthermore, groups of rectangular plan distribution exhibit greater lateral capacity if subjected to lateral horizontal load in the direction of its long axis. Additionally, the research emphasizes that the presence of vertical compression loading can enhance the lateral capacity of the group. This enhancement depends on the value of the vertical compression load, lateral load direction, and helix location, which highlights the complex interaction effect of these factors on the efficiency of helical-pile groups.

Keywords: helical piles, experimental, numerical, lateral loading, group efficiency

Procedia PDF Downloads 33

Authors: Sweta Sinha

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Rapid evolution of technology has changed language pedagogy as well as perspectives on language use, leading to strategic changes in discourse studies. We are now firmly embedded in a time when digital technologies have become an integral part of our daily lives. This has led to generalized approaches to English Language Teaching (ELT) which has raised two-pronged concerns in linguistically diverse settings: a) the diverse linguistic background of the learner might interfere/ intervene with the learning process and b) the differential level of already acquired knowledge of target language might make the classroom practices too easy or too difficult for the target group of learners. ELT needs a more systematic and differential pedagogical approach for greater efficiency and accuracy. The present research analyses the need of identifying learner groups based on different levels of target language proficiency based on a longitudinal study done on 150 undergraduate students. The learners were divided into five groups based on their performance on a twenty point scale in Listening Speaking Reading and Writing (LSRW). The groups were then subjected to varying durations of technology aided language learning sessions and their performance was recorded again on the same scale. Identifying groups and introducing differential teaching and learning strategies led to better results compared to generalized teaching strategies. Language teaching includes different aspects: the organizational, the technological, the sociological, the psychological, the pedagogical and the linguistic. And a facilitator must account for all these aspects in a carefully devised differential approach meeting the challenge of learner diversity. Apart from the justification of the formation of differential groups the paper attempts to devise framework to account for all these aspects in order to make ELT in multilingual setting much more effective.

Keywords: differential groups, English language teaching, language pedagogy, multilingualism, technology aided language learning

Procedia PDF Downloads 391

Authors: Sachini Wickramanayaka

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The occurrence of natural disasters has increased in an alarming rate in recent times due to escalating effects of climate change. One such natural disaster that has continued to grow in frequency and intensity is ‘flooding’, adversely affecting communities around the globe. This is an exploration on how architecture can intervene and facilitate in preserving communities in the face of disaster, specifically in battling floods. ‘Resilience’ is one of the concepts that have been brought forward to be instilled in vulnerable communities to lower the impact from such disasters as a preventative and coping mechanism. While there are number of ways to achieve resilience in the built environment, this paper aims to create a synthesis between resilience and ‘urban acupuncture’. It will consider strengthening communities from within, by layering a network of relatively small-scale, fast phased interventions on pre-existing conventional flood preventative large-scale engineering infrastructure.By investigating ‘The Woodlands’, a planned neighborhood as a case study, this paper will argue that large-scale water management solutions while extremely important will not suffice as a single solution particularly during a time of frequent and extreme weather events. The different projects will try to synthesize non-architectural aspects such as neighborhood aspirations, requirements, potential and awareness into a network of architectural forms that would collectively increase neighborhood resiliency to floods. A mapping study of the selected study area will identify the problematic areas that flood in the neighborhood while the empirical data from previously implemented case studies will assess the success of each solution.If successful the different solutions for each of the identified problem areas will exhibithow flooding and water management can be integrated as part and parcel of daily life.

Keywords: acupuncture, architecture, resiliency, micro-interventions, neighborhood

Procedia PDF Downloads 170

Authors: Naomi Nathan

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Introduction Digitalization of medical education can revolutionize how medical students learn and interact with the medical curriculum across contexts. With the increasing availability of the internet and mobile connectivity in LMICs, online medical education platforms and digital learning tools are becoming more widely available, providing new opportunities for learners to access high-quality medical education and training. However, the adoption and integration of digital technologies in medical education in LMICs is a complex process influenced by various factors, including learners' perceptions and attitudes toward digital learning. In Ethiopia, the adoption of digital platforms for medical education has been slow, with traditional face-to-face teaching methods still being the norm. However, as access to technology improves and more universities adopt digital platforms, it is crucial to understand how medical students perceive this shift. Methodology This study investigated medical students' perception of the digitalization of medical education in relation to their access to the Lecturio Digital Medical Education Platform through a capacity-building project. 740 medical students from over 20 medical universities participated in the study. The students were surveyed using a questionnaire that included their attitudes toward the digitalization of medical education, their frequency of use of the digital platform, and their perceived benefits and challenges. Results The study results showed that most medical students had a positive attitude toward digitalizing medical education. The most commonly cited benefit was the convenience and flexibility of accessing course material/curriculum online. Many students also reported that they found the platform more interactive and engaging, leading to a more meaningful learning experience. The study also identified several challenges medical students faced when using the platform. The most commonly reported challenge was the need for more reliable internet access, which made it difficult for students to access content consistently. Overall, the results of this study suggest that medical students in Ethiopia have a positive perception of the digitalization of medical education. Over 97% of students continuously expressed a need for access to the Lecturio platform throughout their studies. Conclusion Significant challenges still need to be addressed to fully realize the Lecturio digital platform's benefits. Universities, relevant ministries, and various stakeholders must work together to address these challenges to ensure that medical students fully participate in and benefit from digitalized medical education - sustainably and effectively.

Keywords: digital medical education, EdTech, LMICs, e-learning

Procedia PDF Downloads 92

Authors: Salma A. El-Marasy, Reham M. Abd-Elsalam, Omar A. Ahmed-Farid

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Dementia is characterized by impairments in memory and other cognitive abilities. This study aims to elucidate the possible ameliorative effect of silymarin on scopolamine-induced dementia using the object recognition test (ORT). The study was extended to demonstrate the role of cholinergic activity, oxidative stress, neuroinflammation, brain neurotransmitters and histopathological changes in the anti-amnestic effect of silymarin in demented rats. Wistar rats were pretreated with silymarin (200, 400, 800 mg/kg) or donepezil (10 mg/kg) orally for 14 consecutive days. Dementia was induced after the last drug administration by a single intraperitoneal dose of scopolamine (16 mg/kg). Then behavioral, biochemical, histopathological, and immunohistochemical analyses were then performed. Rats pretreated with silymarin counteracted scopolamine-induced non-spatial working memory impairment in the ORT and decreased acetylcholinesterase (AChE) activity, reduced malondialdehyde (MDA), elevated reduced glutathione (GSH), restored gamma-aminobutyric acid (GABA) and dopamine (DA) contents in the cortical and hippocampal brain homogenates. Silymarin dose-dependently reversed scopolamine-induced histopathological changes. Immunohistochemical analysis showed that silymarin dose-dependently mitigated protein expression of a glial fibrillary acidic protein (GFAP) and nuclear factor kappa-B (NF-κB) in the brain cortex and hippocampus. All these effects of silymarin were similar to that of the standard anti-amnestic drug, donepezil. This study reveals that the ameliorative effect of silymarin on scopolamine-induced dementia in rats using the ORT maybe in part mediated by, enhancement of cholinergic activity, anti-oxidant and anti-inflammatory activities as well as mitigation in brain neurotransmitters and histopathological changes.

Keywords: dementia, donepezil, object recognition test, rats, silymarin, scopolamine

Procedia PDF Downloads 138

Authors: Rosanna Tramutoli

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Studies on several languages have demonstrated how different emotions are categorized in various linguistic constructions. It exists in several writings on the codification of emotions in Western African languages. A recent study on the semantic description of Swahili body terminology has demonstrated that body part terms, such as moyo (heart), uso (face) and jicho (eye) are involved in several metaphorical expressions describing emotions. However, so far hardly anything has been written on the linguistic description of emotions in Swahili. Thus, this study describes how emotional concepts, such as ‘love’ and ‘anger’ are codified in Swahili, in order to highlight common semantic and syntactic patterns, etymological sources and metaphorical expressions. The research seeks to answer a number of questions, such as which are the Swahili terms for ‘emotions’? Is there a distinction between ‘emotions’ and ‘feelings’? Which emotional lexical items have Bantu origin and which come from Arabic? Which metaphorical expressions/cognitive schemas are used to codify emotions? (e.g. kumpanda mtu kichwani, lit. ‘to climb on somebody’s head’, to make somebody feel angry, kushuka moyo, lit. ‘to be down the heart’, to feel discouraged, kumpa mtu moyo lit. ‘to give someone heart’, to encourage someone). Which body terms are involved as ‘containers/locus of emotions’? For instance, it has been shown that moyo (‘heart’) occurs as container of ‘love’ (e.g. kumtia mtu moyoni, lit. ‘to put somebody in the heart’, to love somebody very much) and ‘kindness’ (moyo wake ulijaa hisani, ‘his heart was filled with kindness’). The study also takes into account the syntactic patterns used to code emotions. For instance, when does the experiencer occur in subject position? (e.g. nina furaha, nimefurahi, ‘I am happy’) and when in object position (e.g. Huruma iliniingia moyoni, lit. ‘Pity entered me inside my heart’, ‘I felt pity’)? Data have been collected mostly through the analysis of Swahili digital corpora, containing different kinds of Swahili texts (e.g. novels, drama, political essays).

Keywords: emotions, cognitive linguistics, metaphors, Swahili

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Authors: Mohd Zubairy Bin Shamsudin

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Work-related Musculoskeletal Disorder (WMSDs) is one of the occupational health problems encountered by workers over the world. In Malaysia, there is increasing in trend over the years, particularly in the manufacturing sectors. Current method to observe workplace WMSDs is self-report questionnaire, observation and direct measurement. Observational method is most frequently used by the researcher and practitioner because of the simplified, quick and versatile when it applies to the worksite. However, there are some limitations identified e.g. some approach does not cover a wide spectrum of biomechanics activity and not sufficiently sensitive to assess the actual risks. This paper elucidates the development of Work Movement Task Analysis (WMTA), which is an observational tool for industrial practitioners’ especially untrained personnel to assess WMSDs risk factors and provide a basis for suitable intervention. First stage of the development protocol involved literature reviews, practitioner survey, tool validation and reliability. A total of six themes/comments were received in face validity stage. New revision of WMTA consisted of four sections of postural (neck, back, shoulder, arms, and legs) and associated risk factors; movement, load, coupling and basic environmental factors (lighting, noise, odorless, heat and slippery floor). For inter-rater reliability study shows substantial agreement among rater with K = 0.70. Meanwhile, WMTA validation shows significant association between WMTA score and self-reported pain or discomfort for the back, shoulder&arms and knee&legs with p<0.05. This tool is expected to provide new workplace ergonomic observational tool to assess WMSDs for the next stage of the case study.

Keywords: assessment, biomechanics, musculoskeletal disorders, observational tools

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Authors: Collen Kawiya

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In an effort of reducing post-harvest losses and improving the supply of quality fish products in Malawi, the fish solar tent dryers have been designed in the southern part of Lake Malawi for processing small fish species under the project of Cultivate Africa’s Future (CultiAF). This study was done to promote the adoption of the fish solar tent dryers by the many small scale fish processors in Malawi through the assessment of the economic viability of these dryers. With the use of the project’s baseline survey data, a business model for a constructed ‘ready for use’ solar tent dryer was developed where investment appraisal techniques were calculated in addition with the sensitivity analysis. The study also conducted a risk analysis through the use of the Monte Carlo simulation technique and a probabilistic net present value was found. The investment appraisal results showed that the net present value was US$8,756.85, the internal rate of return was 62% higher than the 16.32% cost of capital and the payback period was 1.64 years. The sensitivity analysis results showed that only two input variables influenced the fish solar dryer investment’s net present value. These are the dried fish selling prices that were correlating positively with the net present value and the fresh fish buying prices that were negatively correlating with the net present value. Risk analysis results showed that the chances that fish processors will make a loss from this type of investment are 17.56%. It was also observed that there exist only a 0.20 probability of experiencing a negative net present value from this type of investment. Lastly, the study found that the net present value of the fish solar tent dryer’s investment is still robust in spite of any changes in the levels of investors risk preferences. With these results, it is concluded that the fish solar tent dryers in Malawi are an economically viable investment because they are able to improve the returns in the fish processing activity. As such, fish processors need to adopt them by investing their money to construct and use them.

Keywords: investment appraisal, risk analysis, sensitivity analysis, solar tent drying

Procedia PDF Downloads 279

Authors: Jasmina Pluncevic Gligoroska, Sanja Manchevska, Vaska Antevska, Lidija Todorovska, Beti Dejanova, Sunchica Petrovska, Ivanka Karagjozova, Elizabeta Sivevska

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Introduction: Anthropometric measurements are integral part of regular medical examinations of athletes. In addition to the quantification of the size of the body, these measurements indicate the quality of the physical status, because of its association with sports performance. The purpose of this study was to examine whether there are differences in anthropometric parameters and body mass components in female athletes who participate in two different types of sports. Methods: A total of 27 athletes, 15 handball players and 12 basketball players, at the average age of 22.7 years (age span from 17 to 30 years) entered the study. Anthropometric method by Matiegka was used for determination of body components. Sixteen anthropometric measures were taken: height, weight, four diameters of joints, four circumferences of limbs and six skin folds. Results: Handball players were 169.6±6.7 cm tall and 63,75±7.5 kg heavy. Their average relative muscle mass (absolute mass in kg) was 51% (32.5kg), while bone component was 16.8% (10.7kg) and fat component was 14.3% (7.74kg). The basketball players were 177.4±8.2cm tall and 70.37±12.1kg heavy. Their average relative muscle mass (absolute mass in kg) was 51.9 % (36.6kg), bone component was 16.37% (11.5kg) and fat component was 15.36% (9.4kg). The comparison of anthropometric values showed that basketball players were statistically significantly higher and heavier than handball players (p<0.05). Statistically significant difference (p<0.05) was observed in the range of upper leg circumference (higher in basketball players) and the forearm skin fold (higher in the basketball players). Conclusion: Handball players and basketball players significantly differed in basic anthropometric measures (height and weight), but the body components had almost identical values. The anthropometric measurements that have been taken did not show significant difference between handball and basketball female players despite the different physical demands of the games.

Keywords: anthropometry, body components, basketball, handball female players

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Authors: Rutuja Upadhyay, Anurag Mehra

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Solid food foams/cellular foods are colloidal systems which impart structure, texture and mouthfeel to many food products such as bread, cakes, ice-cream, meringues, etc. Their heterogeneous morphology makes the quantification of structure/mechanical relationships complex. The porous structure of solid food foams is highly influenced by the processing conditions, ingredient composition, and their interactions. Sensory perceptions of food foams are dependent on bubble size, shape, orientation, quantity and distribution and determines the texture of foamed foods. The state and structure of the solid matrix control the deformation behavior of the food, such as elasticity/plasticity or fracture, which in turn has an effect on the force-deformation curves. The obvious step in obtaining the relationship between the mechanical properties and the porous structure is to quantify them simultaneously. Here, we attempt to research food foams such as bread dough, baked bread and steamed rice cakes to determine the link between ingredients and the corresponding effect of each of them on the rheology, microstructure, bubble size and texture of the final product. Dynamic rheometry (SAOS), confocal laser scanning microscopy, flatbed scanning, image analysis and texture profile analysis (TPA) has been used to characterize the foods studied. In all the above systems, there was a common observation that when the mean bubble diameter is smaller, the product becomes harder as evidenced by the increase in storage and loss modulus (G′, G″), whereas when the mean bubble diameter is large the product is softer with decrease in moduli values (G′, G″). Also, the bubble size distribution affects texture of foods. It was found that bread doughs with hydrocolloids (xanthan gum, alginate) aid a more uniform bubble size distribution. Bread baking experiments were done to study the rheological changes and mechanisms involved in the structural transition of dough to crumb. Steamed rice cakes with xanthan gum (XG) addition at 0.1% concentration resulted in lower hardness with a narrower pore size distribution and larger mean pore diameter. Thus, control of bubble size could be an important parameter defining final food texture.

Keywords: food foams, rheology, microstructure, texture

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Authors: Irene Carter, Roy Hanes, Judy MacDonald

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Considering that disability is universal and people with disabilities are part of all societies; that there is a connection between the disabled individual and the societal; and that it is society and social arrangements that disable people with impairments, contemporary disability discourse emphasizes the social model of disability to counter medical and rehabilitative models of disability. However, the social model does not go far enough in addressing the issues of oppression and inclusion. The authors indicate that the social model does not specifically or adequately denote the oppression of persons with disabilities, which is a central component of progressive social work practice with people with disabilities. The social model of disability does not go far enough in deconstructing disability and offering social workers, as well as people with disabilities a way of moving forward in terms of practice anchored in individual, familial and societal change. The social model of disability is expanded by incorporating principles of anti-oppression social work practice. Although the contextual analysis of the social model of disability is an important component there remains a need for social workers to provide service to individuals and their families, which will be illustrated through anti-oppressive practice (AOP). By applying an anti-oppressive model of practice to the above definitions, the authors not only deconstruct disability paradigms but illustrate how AOP offers a framework for social workers to engage with people with disabilities at the individual, familial and community levels of practice, promoting an emancipatory focus in working with people with disabilities. An anti- social- oppression social work model of disability connects the day-to-day hardships of people with disabilities to the direct consequence of oppression in the form of ableism. AOP theory finds many of its basic concepts within social-oppression theory and the social model of disability. It is often the case that practitioners, including social workers and psychologists, define people with disabilities’ as having or being a problem with the focus placed upon adjustment and coping. A case example will be used to illustrate how an AOP paradigm offers social work a more comprehensive and critical analysis and practice model for social work practice with and for people with disabilities than the traditional medical model, rehabilitative and social model approaches.

Keywords: anti-oppressive practice, disability, people with disabilities, social model of disability

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Authors: Ramin Dabirian, Yi Zhang, Ilias Gavrielatos, Ram Mohan, Ovadia Shoham

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Oil-water emulsions can be found in almost every part of the petroleum industry, namely in reservoir rocks, drilling cuttings circulation, production in wells, transportation pipelines, surface facilities and refining process. However, it is necessary for oil production and refinery engineers to resolve the petroleum emulsion problems as well as to eliminate the contaminants in order to meet environmental standards, achieve the desired product quality and to improve equipment reliability and efficiency. A state-of-art Dispersion Characterization Rig (DCR) has been utilized to investigate crude oil-distilled water dispersion separation. Over 80 experimental tests were ran to investigate the flow behavior and stability of the dispersions. The experimental conditions include the effects of water cuts (25%, 50% and 75%), NaCl concentrations (0, 3.5% and 18%), mixture flow velocities (0.89 and 1.71 ft/s), and also orifice place types on the separation rate. The experimental data demonstrate that the water cut can significantly affects the separation time and efficiency. The dispersion with lower water cut takes longer time to separate and have low separation efficiency. The medium and lower water cuts will result in the formation of Mousse emulsion and the phase inversion happens around the medium water cut. The data also confirm that increasing the NaCl concentration in aqueous phase can increase the crude oil water dispersion separation efficiency especially at higher salinities. The separation profile for dispersions with lower salt concentrations has a lower sedimentation rate slope before the inflection point. Dispersions in all tests with higher salt concentrations have a larger sedimenting rate. The presence of NaCl can influence the interfacial tension gradients along the interface and it plays a role in avoiding the Mousse emulsion formation.

Keywords: oil-water dispersion, separation mechanism, phase inversion, emulsion formation

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Authors: Pabitra Sahu, M. Manohari, S. Priyadharshini, R. Santhanam, S. Chandrasekaran, B. Venkatraman

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Radiation workers of reprocessing plants have a potential for internal exposure due to actinides and fission products. Radionuclides like Americium, lead, Polonium and Europium are bone seekers and get accumulated in the skeletal part. As the major skeletal content is in the skull (13%) and knee (22%), measurements of old intake have to be carried out in the skull and knee. At the Indira Gandhi Centre for Atomic Research, a twin HPGe-based actinide monitor is used for the measurement of actinides present in bone. Efficiency estimation, which is one of the prerequisites for the quantification of radionuclides, requires anthropomorphic phantoms. Such phantoms are very limited. Hence, in this study, efficiency curves for a Twin HPGe-based actinide monitoring system are established theoretically using the FLUKA Monte Carlo method and ICRP adult male voxel phantom. In the case of skull measurement, the detector is placed over the forehead, and for knee measurement, one detector is placed over each knee. The efficiency values of radionuclides present in the knee and skull vary from 3.72E-04 to 4.19E-04 CPS/photon and 5.22E-04 to 7.07E-04 CPS/photon, respectively, for the energy range 17 to 3000keV. The efficiency curves for the measurement are established, and it is found that initially, the efficiency value increases up to 100 keV and then starts decreasing. It is found that the skull efficiency values are 4% to 63% higher than that of the knee, depending on the energy for all the energies except 17.74 keV. The reason is the closeness of the detector to the skull compared to the knee. But for 17.74 keV the efficiency of the knee is more than the skull due to the higher attenuation caused in the skull bones because of its greater thickness. The Minimum Detectable Activity (MDA) for 241Am present in the skull and knee is 9 Bq. 239Pu has a MDA of 950 Bq and 1270 Bq for knee and skull, respectively, for a counting time of 1800 sec. This paper discusses the simulation method and the results obtained in the study.

Keywords: FLUKA Monte Carlo Method, ICRP adult male voxel phantom, knee, Skull.

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Authors: Piotr Żabicki, Paweł Skutta

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The project of a glider with an electric motor charged by solar power is an step toward the future of Polish gliding. Due to the popularity of the SZD-50-3 glider and its type of usage, the project was developed based on this model. By placing an auxiliary engine in the glider, the pilot is guaranteed a safe return to the airport. Since it is a training glider, and routes are mainly flown by student pilots and instructors, the guarantee of returning to the airport allows flights in more challenging thermal conditions, which contributes to better pilot training. In case of worsening weather, the pilot has a reliable return option, which prevents time loss due to field landings and saves money by avoiding delays in training. The glider uses the NOVA 15 LW engine, a solar installation, and technical modifications to reduce the glider's weight. This includes the Misztal spar solution, previously used in the PZL 19 aircraft. Additionally, the use of lighter coverings and materials that handle loads from pulling, straining, and sharing improves the aerodynamic performance of the glider, enhancing its overall efficiency. Every component added to the glider's construction (battery, engine, etc.) has been placed to avoid shifting loads along the axis, thus preventing unintended spins and flat spins. Safety concerns were also addressed. In the event of a battery or engine fire, the pilot's cabin is designed as a detachable part of the structure and is made of composites covered with non-flammable resin. The batteries are also enclosed in separate boxes located in the former "luggage" compartment. Access to the installation connecting the engine, panel, and battery is convenient due to the detachable cabin from the structure and the fact that the entire installation runs under the structure. The batteries also have easy access due to the current closed hatch. Cooling for the battery is provided this way.

Keywords: engineering, girder, glider, solar, spar

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Authors: Ahmad Haidar

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Modern economic systems are characterized by growing complexity, and addressing their challenges requires innovative approaches. This study examines the implications of artificial intelligence (AI) on unemployment in Europe from a macroeconomic perspective, employing data modeling techniques to understand the relationship between AI integration and labor market dynamics. To understand the AI-unemployment nexus comprehensively, this research considers factors such as sector-specific AI adoption, skill requirements, workforce demographics, and geographical disparities. The study utilizes a panel data model, incorporating data from European countries over the last two decades, to explore the potential short-term and long-term effects of AI implementation on unemployment rates. In addition to investigating the direct impact of AI on unemployment, the study also delves into the potential indirect effects and spillover consequences. It considers how AI-driven productivity improvements and cost reductions might influence economic growth and, in turn, labor market outcomes. Furthermore, it assesses the potential for AI-induced changes in industrial structures to affect job displacement and creation. The research also highlights the importance of policy responses in mitigating potential negative consequences of AI adoption on unemployment. It emphasizes the need for targeted interventions such as skill development programs, labor market regulations, and social safety nets to enable a smooth transition for workers affected by AI-related job displacement. Additionally, the study explores the potential role of AI in informing and transforming policy-making to ensure more effective and agile responses to labor market challenges. In conclusion, this study provides a comprehensive analysis of the macroeconomic implications of AI on unemployment in Europe, highlighting the importance of understanding the nuanced relationships between AI adoption, economic growth, and labor market outcomes. By shedding light on these relationships, the study contributes valuable insights for policymakers, educators, and researchers, enabling them to make informed decisions in navigating the complex landscape of AI-driven economic transformation.

Keywords: artificial intelligence, unemployment, macroeconomic analysis, european labor market

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Authors: Burcu Ileri, Deniz Sanliyuksel Yucel, Onder Ayyildiz

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The oxidation of pyrite in water results in the formation of acid mine drainage, which typically forms extremely acid mine lake (AML) in the depression areas of abandoned Etili open-pit coal mine site, Northwest Turkey. Nine acid mine lakes of various sizes have been located in the Etili coal mine site. Hayirtepe AML is one of the oldest lake having a mean pH value of 2.9 and conductivity of 4550 μS/cm, and containing elevated concentrations of Al, B, Ba, Ca, Cd, Co, Cr, Cu, Fe, K, Mg, Mn, Na, Ni, Pb, and Zn. The water quality of the lake has been deteriorated due to its high chemical composition, in particular, increasing heavy metal pollution. In this study, fly ash (FA), a coal combustion by-product from fluidized bed thermal power plant in the northwestern part of Turkey, was used as an adsorbent for the treatment of Hayirtepe AML. The FA is a relatively abundant and cost effective material, but its use in adsorption processes usually require excessive adsorbent doses. To increase adsorption efficiency and lower the adsorbent dose, we modified the FA by means of ultrasonic treatment (20 kHz and 40 kHz). The images of scanning electron microscopy (SEM) have demonstrated that ultrasonic treatment not only decreased the size of ash particles but also created pits and cracks on their surfaces which in turn led to a significant increase in the BET surface area. Both FA and modified fly ash were later tested for the removal of heavy metals from the AML. The effect of various operating parameters such as ultrasonic power, pH, ash dose, and adsorption contact time were examined to obtain the optimum conditions for the treatment process. The results have demonstrated that removal of heavy metals by ultrasound-modified fly ash requires much shorter treatment times and lower adsorbent doses than those attained by the unmodified fly ash. This research was financially supported by the Scientific and Technological Research Council of Turkey (TUBITAK), (Project no: 116Y510).

Keywords: acid mine lake, heavy metal, modified fly ash, ultrasonic treatment

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Authors: Abisha Isaac Mohanlal

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Amidst all suspicions and cynicism raised by the legal fraternity, Artificial Intelligence has found its way into the legal system and has revolutionized the conventional forms of legal services delivery. Be it legal argumentation and research or resolution of complex legal disputes; artificial intelligence has crept into all legs of modern day legal services. Its impact has been largely felt by way of big data, legal expert systems, prediction tools, e-lawyering, automated mediation, etc., and lawyers around the world are forced to upgrade themselves and their firms to stay in line with the growth of technology in law. Researchers predict that the future of legal services would belong to artificial intelligence and that the age of human lawyers will soon rust. But as far as the Judiciary is concerned, even in the developed countries, the system has not fully drifted away from the orthodoxy of preferring Natural Intelligence over Artificial Intelligence. Since Judicial decision-making involves a lot of unstructured and rather unprecedented situations which have no single correct answer, and looming questions of legal interpretation arise in most of the cases, discretion and Emotional Intelligence play an unavoidable role. Added to that, there are several ethical, moral and policy issues to be confronted before permitting the intrusion of Artificial Intelligence into the judicial system. As of today, the human judge is the unrivalled master of most of the judicial systems around the globe. Yet, scientists of Artificial Intelligence claim that robot judges can replace human judges irrespective of how daunting the complexity of issues is and how sophisticated the cognitive competence required is. They go on to contend that even if the system is too rigid to allow robot judges to substitute human judges in the recent future, Artificial Intelligence may still aid in other judicial tasks such as drafting judicial documents, intelligent document assembly, case retrieval, etc., and also promote overall flexibility, efficiency, and accuracy in the disposal of cases. By deconstructing the major challenges that Artificial Intelligence has to overcome in order to successfully invade the human- dominated judicial sphere, and critically evaluating the potential differences it would make in the system of justice delivery, the author tries to argue that penetration of Artificial Intelligence into the Judiciary could surely be enhancive and reparative, if not fully transformative.

Keywords: artificial intelligence, judicial decision making, judicial systems, legal services delivery

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Authors: Fernanda Rodriguez

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Breast cancer is pervasive among women, and an increasing number of women are opting for a mastectomy: a medical operation in which one or both breasts are removed with the intention of treating or averting breast cancer. However, there is an emerging population of cancer survivors in European nations that, rather than attempting to reconstruct their breasts to resemble as much as possible ‘normal’ breasts, have turned to dress their scars with decorative tattoos. At a practical level, this study hopes to improve the support systems of these women by possibly providing professionals in the medical field, tattoo artists, and family members of cancer survivors with a deeper understanding of their motivations and decision-making processes for choosing an alternative restorative route - such as decorative tattoos - after their mastectomy. At an intellectual level, however, this study aims to narrow a gap in the academic field concerning the relationship between mastectomies and alternative methods of healing, such as decorative tattoos, as well as to broaden the understanding regarding meaning-making and the ‘normal’ feminine body. Thus, by means of semi-structured interviews and a phenomenological standpoint, this research set itself the goal to understand why do women who have undergone a mastectomy choose to dress their scars with decorative tattoos instead of attempting to regain ‘normalcy’ through breast reconstruction or 3D areola tattoos? The results obtained from the interviews with fifteen women showed that the disillusionment with one part of the other of breast restoration techniques had led these women to find an alternative form of healing that allows them not only to close a painful chapter of their life but also to regain control over their bodies after a period of time in which agency was taking away from them. Decorative post-mastectomy tattoos allow these women to grant their bodies with new meanings and produce their own interpretation of their feminine body and identity.

Keywords: alternative femininity, decorative mastectomy tattoos, gender embodiment, social stigmatization

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Authors: Elisabeth Maidl

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The interdependence of climate change and natural hazard goes along with large uncertainties regarding future risks. Regional stakeholders, experts in natural hazards management and scientists have specific knowledge, resp. mental models on such risks. This diversity of views makes it difficult to find common and broadly accepted prevention measures. If the specific knowledge of these types of actors is shared in an interactive knowledge production process, this enables a broader and common understanding of complex risks and allows to agree on long-term solution strategies. Previous studies on mental models confirm that actors with specific vulnerabilities perceive different aspects of a topic and accordingly prefer different measures. In bringing these perspectives together, there is the potential to reduce uncertainty and to close blind spots in solution finding. However, studies that examine the mental models of regional actors on future concrete mass movement risks are lacking so far. The project tests and evaluates the feasibility of knowledge co-creation for the anticipatory prevention of climate change-induced mass movement risks in the Alps. As a key element, mental models of the three included groups of actors are compared. Being integrated into the research program Climate Change Impacts on Alpine Mass Movements (CCAMM2), this project is carried out in two Swiss mountain regions. The project is structured in four phases: 1) the preparatory phase, in which the participants are identified, 2) the baseline phase, in which qualitative interviews and a quantitative pre-survey are conducted with actors 3) the knowledge-co-creation phase, in which actors have a moderated exchange meeting, and a participatory modelling workshop on specific risks in the region, and 4) finally a public information event. Results show that participants' mental models are based on the place of origin, profession, believes, values, which results in narratives on climate change and hazard risks. Further, the more intensively participants interact with each other, the more likely is that they change their views. This provides empirical evidence on how changes in opinions and mindsets can be induced and fostered.

Keywords: climate change, knowledge-co-creation, participatory process, natural hazard risks

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Authors: Anil Kumar Gupta, Dronadula Venkata Sai Praneeth, Brajesh Dubey, Arundhuti Devi, Suravi Kalita, Khanindra Sharma

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Increase in urbanization and industrialization have led to improve in the standard of living. However, at the same time, the challenges due to improper solid waste management are also increasing. Municipal Solid Waste management is considered as a vital step in the development of urban infrastructure. The present study focuses on developing a solid waste management plan for an urban area in a developing country. The current scenario of solid waste management practices at various urban bodies in India is summarized. Guwahati city in the northeastern part of the country and is also one of the targeted smart cities (under the governments Smart Cities program) was chosen as case study to develop and implement the solid waste management plan. The whole city was divided into various divisions and waste samples were collected according to American Society for Testing and Materials (ASTM) - D5231-92 - 2016 for each division in the city and a composite sample prepared to represent the waste from the entire city. The solid waste characterization in terms of physical and chemical which includes mainly proximate and ultimate analysis were carried out. Existing primary and secondary collection systems were studied and possibilities of enhancing the collection systems were discussed. The composition of solid waste for the overall city was found to be as: organic matters 38%, plastic 27%, paper + cardboard 15%, Textile 9%, inert 7% and others 4%. During the conference presentation, further characterization results in terms of Thermal gravimetric analysis (TGA), pH and water holding capacity will be discussed. The waste management options optimizing activities such as recycling, recovery, reuse and reduce will be presented and discussed.

Keywords: proximate, recycling, thermal gravimetric analysis (TGA), solid waste management

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Authors: Shiran Bord, Assaf Oshri, Matthew W. Carlson, Sihong Liu

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Background: Alcohol-impaired driving (AID) and binge drinking are major health concerns among college students. Although the link between binge drinking and AID is well established, knowledge regarding binge drinking patterns, the factors influencing binge drinking, and the associations between consumption patterns and alcohol-related risk behaviors is lacking. Aims: To examine heterogeneous trajectories of binge drinking during college and tests factors that might predict class membership as well as class membership outcomes. Methods: Data were obtained from a sample of 1,265 college students (Mage = 18.5, SD = .66) as part of the Longitudinal Study of Violence Against Women (N = 1,265; 59.3% female; 69.2% white). Analyses were completed in three stages. First, a growth curve analysis was conducted to identify trajectories of binge drinking over time. Second, growth curve mixture modeling analyses were pursued to assess unobserved growth trajectories of binge drinking without predictors. Lastly, parental drinking variables were added to the model as predictors of class membership, and AID and being a passenger of a drunk driver were added to the model as outcomes. Results: Three binge drinking trajectories were identified: high-convex, medium concave and low-increasing. Parental drinking was associated with being in high-convex and medium-concave classes. Compared to the low-increasing class, the high convex and medium concave classes reported more AID and being a passenger of a drunk driver more frequently. Conclusions: Parental drinking may affect children’s later engagement in AID. Efforts should focus on parents' education regarding the consequences of parental modeling of alcohol consumption.

Keywords: alcohol impaired driving, alcohol consumption, binge drinking, college students, parental modeling

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Authors: Shraddha Acharya, Sharad Kumar Sharma, Ratna Bhattarai, Bhagwan Maharjan, Deepak Dahal, Serpahine Kaminsa

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Background: Drug-resistant (DR) tuberculosis (TB) continues to be a threat in Nepal, with an estimated 2800 new cases every year. The treatment of DR-TB with second line TB drugs is complex and takes longer time with comparatively lower treatment success rate than drug-susceptible TB. Delay in treatment initiation for DR-TB patients might further result in unfavorable treatment outcomes and increased transmission. This study thus aims to determine median time taken to initiate second-line treatment among Rifampicin Resistant (RR) diagnosed TB patients and to assess the proportion of treatment delays among various type of DR-TB cases. Method: A retrospective cohort study was done using national routine electronic data (DRTB and TB Laboratory Patient Tracking System-DHIS2) on drug resistant tuberculosis patients between January 2020 and December 2022. The time taken for treatment initiation was computed as– days from first diagnosis as RR TB through Xpert MTB/Rif test to enrollment on second-line treatment. The treatment delay (>7 days after diagnosis) was calculated. Results: Among total RR TB cases (N=954) diagnosed via Xpert nationwide, 61.4% were enrolled under shorter-treatment regimen (STR), 33.0% under longer treatment regimen (LTR), 5.1% for Pre-extensively drug resistant TB (Pre-XDR) and 0.4% for Extensively drug resistant TB (XDR) treatment. Among these cases, it was found that the median time from diagnosis to treatment initiation was 6 days (IQR:2-15.8). The median time was 5 days (IQR:2.0-13.3) among STR, 6 days (IQR:3.0-15.0) among LTR, 30 days (IQR:5.5-66.8) among Pre-XDR and 4 days (IQR:2.5-9.0) among XDR TB cases. The overall treatment delay (>7 days after diagnosis) was observed in 42.4% of the patients, among which, cases enrolled under Pre-XDR contributed substantially to treatment delay (72.0%), followed by LTR (43.6%), STR (39.1%) and XDR (33.3%). Conclusion: Timely diagnosis and prompt treatment initiation remain fundamental focus of the National TB program. The findings of the study, however suggest gaps in timeliness of treatment initiation for the drug-resistant TB patients, which could bring adverse treatment outcomes. Moreover, there is an alarming delay in second line treatment initiation for the Pre-XDR TB patients. Therefore, this study generates evidence to identify existing gaps in treatment initiation and highlights need for formulating specific policies and intervention in creating effective linkage between the RR TB diagnosis and enrollment on second line TB treatment with intensified efforts from health providers for follow-ups and expansion of more decentralized, adequate, and accessible diagnostic and treatment services for DR-TB, especially Pre-XDR TB cases, due to the observed long treatment delays.

Keywords: drug-resistant, tuberculosis, treatment initiation, Nepal, treatment delay

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