Search results for: postpartum family planning services
Commenced in January 2007
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Edition: International
Paper Count: 9605

Search results for: postpartum family planning services

485 Service Quality, Skier Satisfaction, and Behavioral Intentions in Leisure Skiing: The Case of Beijing

Authors: Shunhong Qi, Hui Tian

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Triggered off by the forthcoming 2022 Winter Olympics, ski centers are blossoming in China, the number being 742 in 2018. Although the number of skier visits of ski resorts soared to 19.7 million in 2018, one-time skiers account for a considerable portion therein. In light of the extremely low return rates and skiing penetration level (0.5%) of leisure skiing in China, this study proposes and tests a leisure ski service performance framework which assesses the ski resorts’ service quality, skier satisfaction, as well as their impact on skiers’ behavioral intentions, with an aim to assess the success of ski resorts and provide suggestions for improvement. Three self-administered surveys and 16 interviews were conducted upon a convenience sample of leisure skiers in two major ski destinations within two hours’ drive from Beijing – Nanshan and Jundushan ski resorts. Of the 680 questionnaires distributed, 416 usable copies were returned, the response rate being 61.2%. The questionnaire used for the study was developed based on the existing literature of 'push' factors of skiers (intrinsic desire) and 'pull' factors (attractiveness of a destination), as well as leisure sport satisfaction. The scale comprises four parts: skiers’ demographic profiles, their perceived service quality (including ski resorts’ infrastructure, expense, safety and comfort, convenience, daily needs support, skill development support, and accessibility), their overall levels of satisfaction (satisfaction with the service and the experience), and their behavioral intentions (including loyalty, future visitation and greater tolerance of price increases). Skiers’ demographic profiles show that among the 220 males and 196 females in the survey, a vast majority of the skiers are age 17-39 (87.2%). 64.7% are not married, and nearly half (48.3%) of the skiers have a monthly family income exceeding 10,000 yuan (USD 1,424), and 80% are beginners or intermediate skiers. The regression examining the influence of service quality on skier satisfaction reveals that service quality accounts for 44.4% of the variance in skier satisfaction, the variables of safety and comfort, expense, skill development support, and accessibility contributing significantly in descending order. Another regression analyzing the influence of service quality as well as skier satisfaction on their behavioral intentions shows that service quality and skier satisfaction account for 39.1% of the variance in skiers’ behavioral intentions, and the significant predictors are skier satisfaction, safety and comfort, expense, and accessibility, in descending order, though a comparison between groups also indicates that for expert skiers, the significant variables are skier satisfaction, skill development support, safety, and comfort. Suggestions are thus made for ski resorts and other stakeholders to improve skier satisfaction and increase visitation: developing diversified ski courses to meet the demands of skiers of different skiing skills and to reduce crowding, adopting enough chairlifts and magic carpets, reinforcing safety measures and medical force; further exploring their various resources and lower the skiing expense on ski pass, equipment renting, accommodation and dining; adding more bus lines and/or develop platforms for skiers’ car-pooling, and offering diversified skiing activities with local flavors for better entertainment.

Keywords: behavioral intentions, leisure skiing, service quality, skier satisfaction

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484 Metamorphosis of Caste: An Examination of the Transformation of Caste from a Material to Ideological Phenomenon in Sri Lanka

Authors: Pradeep Peiris, Hasini Lecamwasam

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The fluid, ambiguous, and often elusive existence of caste among the Sinhalese in Sri Lanka has inspired many scholarly endeavours. Originally, Sinhalese caste was organized according to the occupational functions assigned to various groups in society. Hence cultivators came to be known as Goyigama, washers Dobi, drummers Berava, smiths Navandanna and so on. During pre-colonial times the specialized services of various groups were deployed to build water reservoirs, cultivate the land, and/or sustain the Buddhist order by material means. However, as to how and why caste prevails today in Sinhalese society when labour is in ideal terms free to move where it wants, or in other words, occupation is no longer strictly determined or restricted by birth, is a question worth exploring. Hence this paper explores how, and perhaps more interestingly why, when the nexus between traditional occupations and caste status is fast disappearing, caste itself has managed to survive and continues to be salient in politics in Sri Lanka. In answer to this larger question, the paper looks at caste from three perspectives: 1) Buddhism, whose ethical project provides a justification of social stratifications that transcends economic bases 2) Capitalism that has reactivated and reproduced archaic relations in a process of 'accumulation by subordination', not only by reinforcing the marginality of peripheral caste groups, but also by exploiting caste divisions to hinder any realization of class interests and 3) Democracy whose supposed equalizing effect expected through its ‘one man–one vote’ approach has been subverted precisely by itself, whereby the aggregate ultimately comes down to how many such votes each ‘group’ in society has. This study draws from field work carried out in Dedigama (in the District of Kegalle, Central Province) and Kelaniya (in the District of Colombo, Western Province) in Sri Lanka over three years. The choice of field locations was encouraged by the need to capture rural and urban dynamics related to caste since caste is more apparently manifest in rural areas whose material conditions partially warrant its prevalence, whereas in urban areas it exists mostly in the ideological terrain. In building its analysis, the study has employed a combination of objectivist and subjectivist approaches to capture the material and ideological existence of caste and caste politics in Sinhalese society. Therefore, methods such as in-depth interviews, observation, and collection of demographical and interpretive data from secondary sources were used for this study. The paper has been situated in a critical theoretical framework of social inquiry in an attempt to question dominant assumptions regarding such meta-labels as ‘Capitalism’ and ‘Democracy’, and also the supposed emancipatory function of religion (focusing on Buddhism).

Keywords: Buddhism, capitalism, caste, democracy, Sri Lanka

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483 Scanning Transmission Electron Microscopic Analysis of Gamma Ray Exposed Perovskite Solar Cells

Authors: Aleksandra Boldyreva, Alexander Golubnichiy, Artem Abakumov

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Various perovskite materials have surprisingly high resistance towards high-energy electrons, protons, and hard ionization, such as X-rays and gamma-rays. Superior radiation hardness makes a family of perovskite semiconductors an attractive candidate for single- and multijunction solar cells for the space environment and as X-ray and gamma-ray detectors. One of the methods to study the radiation hardness of different materials is by exposing them to gamma photons with high energies (above 500 keV) Herein, we have explored the recombination dynamics and defect concentration of a mixed cation mixed halide perovskite Cs0.17FA0.83PbI1.8Br1.2 with 1.74 eV bandgap after exposure to a gamma-ray source (2.5 Gy/min). We performed an advanced STEM EDX analysis to reveal different types of defects formed during gamma exposure. It was found that 10 kGy dose results in significant improvement of perovskite crystallinity and homogeneous distribution of I ions. While the absorber layer withstood gamma exposure, the hole transport layer (PTAA) as well as indium tin oxide (ITO) were significantly damaged, which increased the interface recombination rate and reduction of fill factor in solar cells. Thus, STEM analysis is a powerful technique that can reveal defects formed by gamma exposure in perovskite solar cells. Methods: Data will be collected from perovskite solar cells (PSCs) and thin films exposed to gamma ionisator. For thin films 50 μL of the Cs0.17FA0.83PbI1.8Br1.2 solution in DMF was deposited (dynamically) at 3000 rpm followed by quenching with 100 μL of ethyl acetate (dropped 10 sec after perovskite precursor) applied at the same spin-coating frequency. The deposited Cs0.17FA0.83PbI1.8Br1.2 films were annealed for 10 min at 100 °C, which led to the development of a dark brown color. For the solar cells, 10% suspension of SnO2 nanoparticles (Alfa Aesar) was deposited at 4000 rpm, followed by annealing on air at 170 ˚C for 20 min. Next, samples were introduced into a nitrogen glovebox for the deposition of all remaining layers. Perovskite film was applied in the same way as in thin films described earlier. Solution of poly-triaryl amine PTAA (Sigma Aldrich) (4 mg in chlorobenzene) was applied at 1000 rpm atop of perovskite layer. Next, 30 nm of VOx was deposited atop the PTAA layer on the whole sample surface using the physical vapor deposition (PVD) technique. Silver electrodes (100 nm) were evaporated in a high vacuum (10-6 mbar) through a shadow mask, defining the active area of each device as ~0.16 cm2. The prepared samples (thin films and solar cells) were packed in Al lamination foil inside the argon glove box. The set of samples consisted of 6 thin films and 6 solar cells, which were exposed to 6, 10, and 21 kGy (2 samples per dose) with 137Cs gamma-ray source (E = 662 keV) with a dose rate of 2.5 Gy/min. The exposed samples will be studied on a focused ion beam (FIB) on a dual-beam scanning electron microscope from ThermoFisher, the Helios G4 Plasma FIB Uxe, operating with a xenon plasma.

Keywords: perovskite solar cells, transmission electron microscopy, radiation hardness, gamma irradiation

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482 The Use of Telecare in the Re-design of Overnight Supports for People with Learning Disabilities: Implementing a Cluster-based Approach in North Ayrshire

Authors: Carly Nesvat, Dominic Jarrett, Colin Thomson, Wilma Coltart, Thelma Bowers, Jan Thomson

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Introduction: Within Scotland, the Same As You strategy committed to moving people with learning disabilities out of long-stay hospital accommodation into homes in the community. Much of the focus of this movement was on the placement of people within individual homes. In order to achieve this, potentially excessive supports were put in place which created dependence, and carried significant ongoing cost primarily for local authorities. The greater focus on empowerment and community participation which has been evident in more recent learning disability strategy, along with the financial pressures being experienced across the public sector, created an imperative to re-examine that provision, particularly in relation to the use of expensive sleepover supports to individuals, and the potential for this to be appropriately scaled back through the use of telecare. Method: As part of a broader programme of redesigning overnight supports within North Ayrshire, a cluster of individuals living in close proximity were identified, who were in receipt of overnight supports, but who were identified as having the capacity to potentially benefit from their removal. In their place, a responder service was established (an individual staying overnight in a nearby service user’s home), and a variety of telecare solutions were placed within individual’s homes. Active and passive technology was connected to an Alarm Receiving Centre, which would alert the local responder service when necessary. Individuals and their families were prepared for the change, and continued to be informed about progress with the pilot. Results: 4 individuals, 2 of whom shared a tenancy, had their sleepover supports removed as part of the pilot. Extensive data collection in relation to alarm activation was combined with feedback from the 4 individuals, their families, and staff involved in their support. Varying perspectives emerged within the feedback. 3 of the individuals were clearly described as benefitting from the change, and the greater sense of independence it brought, while more concerns were evident in relation to the fourth. Some family members expressed a need for greater preparation in relation to the change and ongoing information provision. Some support staff also expressed a need for more information, to help them understand the new support arrangements for an individual, as well as noting concerns in relation to the outcomes for one participant. Conclusion: Developing a telecare response in relation to a cluster of individuals was facilitated by them all being supported by the same care provider. The number of similar clusters of individuals being identified within North Ayrshire is limited. Developing other solutions such as a response service for redesign will potentially require greater collaboration between different providers of home support, as well as continuing to explore the full range of telecare, including digital options. The pilot has highlighted the need for effective preparatory and ongoing engagement with staff and families, as well as the challenges which can accompany making changes to long-standing packages of support.

Keywords: challenges, change, engagement, telecare

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481 Port Miami in the Caribbean and Mesoamerica: Data, Spatial Networks and Trends

Authors: Richard Grant, Landolf Rhode-Barbarigos, Shouraseni Sen Roy, Lucas Brittan, Change Li, Aiden Rowe

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Ports are critical for the US economy, connecting farmers, manufacturers, retailers, consumers and an array of transport and storage operators. Port facilities vary widely in terms of their productivity, footprint, specializations, and governance. In this context, Port Miami is considered as one of the busiest ports providing both cargo and cruise services in connecting the wider region of the Caribbean and Mesoamerica to the global networks. It is considered as the “Cruise Capital of the World and Global Gateway of the Americas” and “leading container port in Florida.” Furthermore, it has also been ranked as one of the top container ports in the world and the second most efficient port in North America. In this regard, Port Miami has made significant investments in the strategic and capital infrastructure of about US$1 billion, including increasing the channel depth and other onshore infrastructural enhancements. Therefore, this study involves a detailed analysis of Port Miami’s network, using publicly available multiple years of data about marine vessel traffic, cargo, and connectivity and performance indices from 2015-2021. Through the analysis of cargo and cruise vessels to and from Port Miami and its relative performance at the global scale from 2015 to 2021, this study examines the port’s long-term resilience and future growth potential. The main results of the analyses indicate that the top category for both inbound and outbound cargo is manufactured products and textiles. In addition, there are a lot of fresh fruits, vegetables, and produce for inbound and processed food for outbound cargo. Furthermore, the top ten port connections for Port Miami are all located in the Caribbean region, the Gulf of Mexico, and the Southeast USA. About half of the inbound cargo comes from Savannah, Saint Thomas, and Puerto Plata, while outbound cargo is from Puerto Corte, Freeport, and Kingston. Additionally, for cruise vessels, a significantly large number of vessels originate from Nassau, followed by Freeport. The number of passenger's vessels pre-COVID was almost 1,000 per year, which dropped substantially in 2020 and 2021 to around 300 vessels. Finally, the resilience and competitiveness of Port Miami were also assessed in terms of its network connectivity by examining the inbound and outbound maritime vessel traffic. It is noteworthy that the most frequent port connections for Port Miami were Freeport and Savannah, followed by Kingston, Nassau, and New Orleans. However, several of these ports, Puerto Corte, Veracruz, Puerto Plata, and Santo Thomas, have low resilience and are highly vulnerable, which needs to be taken into consideration for the long-term resilience of Port Miami in the future.

Keywords: port, Miami, network, cargo, cruise

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480 Developing a Roadmap by Integrating of Environmental Indicators with the Nitrogen Footprint in an Agriculture Region, Hualien, Taiwan

Authors: Ming-Chien Su, Yi-Zih Chen, Nien-Hsin Kao, Hideaki Shibata

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The major component of the atmosphere is nitrogen, yet atmospheric nitrogen has limited availability for biological use. Human activities have produced different types of nitrogen related compounds such as nitrogen oxides from combustion, nitrogen fertilizers from farming, and the nitrogen compounds from waste and wastewater, all of which have impacted the environment. Many studies have indicated the N-footprint is dominated by food, followed by housing, transportation, and goods and services sectors. To solve the impact issues from agricultural land, nitrogen cycle research is one of the key solutions. The study site is located in Hualien County, Taiwan, a major rice and food production area of Taiwan. Importantly, environmentally friendly farming has been promoted for years, and an environmental indicator system has been established by previous authors based on the concept of resilience capacity index (RCI) and environmental performance index (EPI). Nitrogen management is required for food production, as excess N causes environmental pollution. Therefore it is very important to develop a roadmap of the nitrogen footprint, and to integrate it with environmental indicators. The key focus of the study thus addresses (1) understanding the environmental impact caused by the nitrogen cycle of food products and (2) uncovering the trend of the N-footprint of agricultural products in Hualien, Taiwan. The N-footprint model was applied, which included both crops and energy consumption in the area. All data were adapted from government statistics databases and crosschecked for consistency before modeling. The actions involved with agricultural production were evaluated and analyzed for nitrogen loss to the environment, as well as measuring the impacts to humans and the environment. The results showed that rice makes up the largest share of agricultural production by weight, at 80%. The dominant meat production is pork (52%) and poultry (40%); fish and seafood were at similar levels to pork production. The average per capita food consumption in Taiwan is 2643.38 kcal capita−1 d−1, primarily from rice (430.58 kcal), meats (184.93 kcal) and wheat (ca. 356.44 kcal). The average protein uptake is 87.34 g capita−1 d−1, and 51% is mainly from meat, milk, and eggs. The preliminary results showed that the nitrogen footprint of food production is 34 kg N per capita per year, congruent with the results of Shibata et al. (2014) for Japan. These results provide a better understanding of the nitrogen demand and loss in the environment, and the roadmap can furthermore support the establishment of nitrogen policy and strategy. Additionally, the results serve to develop a roadmap of the nitrogen cycle of an environmentally friendly farming area, thus illuminating the nitrogen demand and loss of such areas.

Keywords: agriculture productions, energy consumption, environmental indicator, nitrogen footprint

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479 Young Adult Males’ Attitudes, Perceptions and Behaviours in Regards to Male Condoms in Cambodia: A Qualitative Study

Authors: Rebecca Johnson, Elizabeth Hoban

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Condom use among young men in Cambodia has declined between 2005 and 2014 which has public health implications such as increased risks of sexually transmitted infections, including HIV, and unplanned pregnancies. Conversations about sexual and reproductive health issues, including condom use, are not socially sanctioned in Cambodian society leaving young adults with limited knowledge of, and poor access to sexual and reproductive health services. Additionally, men play a dominant role in decision making regarding condom use within sexual partnerships. This study sought to fill a gap in knowledge by exploring young adult males’ attitudes, perceptions and behaviours regarding condom use. In February and March 2018, twenty young adult males, aged 18 to 24 years, were recruited from urban, peri urban and rural areas in Cambodia. The young adult males participated in a face-to-face semi structured interview that used an interview guide and photo elicitation method. The interview explored participants’ knowledge of sexual and reproductive health issues and efficacy, sexual behaviours, and use of condoms. Inductive thematic analysis was conducted and the following major themes emerged: understanding of reproduction, understanding of sexually transmitted infections, knowledge about condoms, condom use, access to condoms, and sexual behaviour. Participants’ knowledge of condoms and specific reasons for their use varied; most participants understood that condoms provide protection from sexually transmitted infections and prevent pregnancy. Stigma associated with condom access was consistently referred to as a problem and the main reason cited by young men for not using condoms during sexual intercourse. The perceived importance of condom use altered with partner type and relationship status, dependent upon the need for protection from sexually transmitted infections or pregnancy. Condoms were used for infection control in the context of multiple relationships, or as a contraceptive method for unmarried and some married couples. The majority of young men engaged in premarital sexual intercourse, of those men the many used condoms. The inconsistent use of condoms by young men in Cambodia is of public health concern because of the increased risk of sexually transmitted infections (including HIV), and unplanned pregnancy. Public health action is required in order to minimize long term health issues for individuals and the community. Health education is required to increase knowledge of condom use, sexually transmitted infections and HIV, and reduce the stigma associated with this topic. Sustainable health promotion programs are needed to increase ease of access to condoms for young people. Public health policy in Cambodia needs to be reviewed to improve sexual and reproductive health outcomes for young adults.

Keywords: Cambodia, condom use, sexual and reproductive health, young adult males

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478 Assessment of the Environmental Compliance at the Jurassic Production Facilities towards HSE MS Procedures and Kuwait Environment Public Authority Regulations

Authors: Fatemah Al-Baroud, Sudharani Shreenivas Kshatriya

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Kuwait Oil Company (KOC) is one of the companies for gas & oil production in Kuwait. The oil and gas industry is truly global; with operations conducted in every corner of the globe, the global community will rely heavily on oil and gas supplies. KOC has made many commitments to protect all due to KOC’s operations and operational releases. As per KOC’s strategy, the substantial increase in production activities will bring many challenges in managing various environmental hazards and stresses in the company. In order to handle those environmental challenges, the need of implementing effectively the health, safety, and environmental management system (HSEMS) is significant. And by implementing the HSEMS system properly, the environmental aspects of the activities, products, and services were identified, evaluated, and controlled in order to (i) Comply with local regulatory and other obligatory requirements; (ii) Comply with company policy and business requirements; and (iii) Reduce adverse environmental impact, including adverse impact to company reputation. Assessments for the Jurassic Production Facilities are being carried out as a part of the KOC HSEMS procedural requirement and monitoring the implementation of the relevant HSEMS procedures in the facilities. The assessments have been done by conducting series of theme audits using KOC’s audit protocol at JPFs. The objectives of the audits are to evaluate the compliance of the facilities towards the implementation of environmental procedures and the status of the KEPA requirement at all JPFs. The list of the facilities that were covered during the theme audit program are the following: (1) Jurassic Production Facility (JPF) – Sabriya (2) Jurassic Production Facility (JPF) – East Raudhatian (3) Jurassic Production Facility (JPF) – West Raudhatian (4)Early Production Facility (EPF 50). The auditing process comprehensively focuses on the application of KOC HSE MS procedures at JPFs and their ability to reduce the resultant negative impacts on the environment from the operations. Number of findings and observations were noted and highlighted in the audit reports and sent to all concerned controlling teams. The results of these audits indicated that the facilities, in general view, were in line with KOC HSE Procedures, and there were commitments in documenting all the HSE issues in the right records and plans. Further, implemented several control measures at JPFs that minimized/reduced the environmental impact, such as SRU were installed for sulphur recovery. Future scope and monitoring audit after a sufficient period of time will be carried out in conjunction with the controlling teams in order to verify the current status of the recommendations and evaluate the contractors' performance towards the required actions in preserving the environment.

Keywords: assessment of the environmental compliance, environmental and social impact assessment, kuwait environment public authority regulations, health, safety and environment management procedures, jurassic production facilities

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477 The First Complete Mitochondrial Genome of Melon Thrips, Thrips palmi (Thripinae: Thysanoptera): Vector for Tospoviruses

Authors: Kaomud Tyagi, Rajasree Chakraborty, Shantanu Kundu, Devkant Singha, Kailash Chandra, Vikas Kumar

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The melon thrips, Thrips palmi is a serious pest of a wide range of agriculture crops and also act as vectors for plant viruses (genus Tospovirus, family Bunyaviridae). More molecular data on this species is required to understand the cryptic speciation and evolutionary affiliations. Mitochondrial genomes have been widely used in phylogenetic and evolutionary studies in insect. So far, mitogenomes of five thrips species (Anaphothrips obscurus, Frankliniella intonsa, Frankliniella occidentalis, Scirtothrips dorsalis and Thrips imaginis) is available in the GenBank database. In this study, we sequenced the first complete mitogenome T. palmi and compared it with available thrips mitogenomes. We assembled the mitogenome from the whole genome sequencing data generated using Illumina Hiseq2500. Annotation was performed using MITOS web-server to estimate the location of protein coding genes (PCGs), transfer RNA (tRNAs), ribosomal RNAs (rRNAs) and their secondary structures. The boundaries of PCGs and rRNAs was confirmed manually in NCBI. Phylogenetic analyses were performed using the 13 PCGs data using maximum likelihood (ML) in PAUP, and Bayesian inference (BI) in MrBayes 3.2. The complete mitogenome of T. palmi was 15,333 base pairs (bp), which was greater than the genomes of A. obscurus (14,890bp), F. intonsa (15,215 bp), F. occidentalis (14,889 bp) and S. dorsalis South Asia strain (SA1) (14,283 bp), but smaller than the genomes of T. imaginis (15,407 bp) and S. dorsalis East Asia strain (EA1) (15,343bp). Like in other thrips species, the mitochondrial genome of T. palmi was represented by 37 genes, including 13 PCGs, large and small ribosomal RNA (rrnL and rrnS) genes, 22 transfer RNA (tRNAs) genes (with one extra gene for trn-Serine) and two A+T-rich control regions (CR1 and CR2). Thirty one genes were observed on heavy (H) strand and six genes on the light (L) strand. The six tRNA genes (trnG,trnK, trnY, trnW, trnF, and trnH) were found to be conserved in all thrips species mitogenomes in their locations relative to a protein-coding or rRNA gene upstream or downstream. The gene arrangements of T. palmi is very close to T. imaginis except the rearrangements in tRNAs genes: trnR (arginine), and trnE (glutamic acid) were found to be located between cox3 and CR2 in T. imaginis which were translocated between atp6 and CR1 in T. palmi; trnL1 (Leucine) and trnS1(Serine) were located between atp6 and CR1 in T. imaginis which were translocated between cox3 and CR2 in T. palmi. The location of CR1 upstream of nad5 gene was suggested to be ancestral condition of the thrips species in subfamily Thripinae, was also observed in T. palmi. Both the Maximum likelihood (ML) and Bayesian Inference (BI) phylogenetic trees generated resulted in similar topologies. The T. palmi was clustered with T. imaginis. We concluded that more molecular data on the diverse thrips species from different hierarchical level is needed, to understand the phylogenetic and evolutionary relationships among them.

Keywords: thrips, comparative mitogenomics, gene rearrangements, phylogenetic analysis

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476 The Influence of Perinatal Anxiety and Depression on Breastfeeding Behaviours: A Qualitative Systematic Review

Authors: Khulud Alhussain, Anna Gavine, Stephen Macgillivray, Sushila Chowdhry

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Background: Estimates show that by the year 2030, mental illness will account for more than half of the global economic burden, second to non-communicable diseases. Often, the perinatal period is characterised by psychological ambivalence and a mixed anxiety-depressive condition. Maternal mental disorder is associated with perinatal anxiety and depression and affects breastfeeding behaviors. Studies also indicate that maternal mental health can considerably influence a baby's health in numerous aspects and impact the newborn health due to lack of adequate breastfeeding. However, studies reporting factors associated with breastfeeding behaviors are predominantly quantitative. Therefore, it is not clear what literature is available to understand the factors affecting breastfeeding and perinatal women’s perspectives and experiences. Aim: This review aimed to explore the perceptions and experiences of women with perinatal anxiety and depression, as well as how these experiences influence their breastfeeding behaviours. Methods: A systematic literature review of qualitative studies in line with the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ). Four electronic databases (CINAHL, PsycINFO, Embase, and Google Scholar) were explored for relevant studies using a search strategy. The search was restricted to studies published in the English language between 2000 and 2022. Findings from the literature were screened using a pre-defined screening criterion and the quality of eligible studies was appraised using the Walsh and Downe (2006) checklist. Findings were extracted and synthesised based on Braun and Clark. The review protocol was registered on PROSPERO (Ref: CRD42022319609). Result: A total of 4947 studies were identified from the four databases. Following duplicate removal and screening 16 studies met the inclusion criteria. The studies included 87 pregnant and 302 post-partum women from 12 countries. The participants were from a variety of economic, regional, and religious backgrounds, mainly from the age of 18 to 45 years old. Three main themes were identified: Barriers to breastfeeding, breastfeeding facilitators, emotional disturbance, and breastfeeding. Seven subthemes emerged from the data: expectation versus reality, uncertainly about maternal competencies, body image and breastfeeding, lack of sufficient breastfeeding support for family and caregivers’ support, influences positive breastfeeding practices, breastfeeding education, and causes of mental strain among breastfeeding women. Breastfeeding duration is affected in women with mental health disorders, irrespective of their desire to breastfeed. Conclusion: There is significant empirical evidence that breastfeeding behaviour and perinatal mental disturbance are linked. However, there is a lack of evidence to apply the findings to Saudi women due to lack of empirical qualitative information. To improve the psychological well-being of mothers, it is crucial to explore and recognise any concerns with their mental, physical, and emotional well-being. Therefore, robust research is needed so that breastfeeding intervention researchers and policymakers can focus on specifically what needs to be done to help mentally distressed perinatal women and their new-born.

Keywords: pregnancy, perinatal period, anxiety, depression, emotional disturbance, breastfeeding

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475 Employment of Persons with Disabilities in Georgia: Challenges and Perspectives

Authors: Tamar Makharadze, Anastasia Kitiashvili, Irine Zhvania, Tamar Abashidze

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After ratification of UN Convention on the Rights of Persons with Disabilities (UN CRPD) by the Parliament of Georgia in 2013, ensuring equal access to education and employment for people with disabilities has become one of the priorities of the government. The current research has analyzed the attitudes of people with disabilities, employers and society towards various challenges that employment of persons with disabilities faces in Georgia. The study has been carried out in the capital city and three towns in West and East Georgia. Both quantitative and qualitative research methods have been used. Employers’ attitudes have been studied by analyzing research data from six focus groups and 12 in-depth interviews. Views of persons with disabilities have been analyzed relied on data from eight focus groups and 14 in-depth interviews. The quantitative study covered 490 surveyed respondents from four cities in Georgia. The research was carried out with the employees of companies selected based on the Simple Random Sample; in each company, based on the size of the company 7–10 employees were surveyed. A survey was conducted using a specially developed structured questionnaire. Data analysis was carried out using SPSS (21.0). The research was carried out during June-August 2015. The research data shows that both qualitative and quantitative research participants view employment of persons with disabilities positively; however persons with severe intellectual disabilities and mental problems are viewed as less workable and desired at workplaces. The respondents support the idea of employment of persons with disabilities at an open labour market; at the same time idea of a development of sheltered workshops is also supported. The vast majority of research participants believe that employers should be rather encouraged to hire persons with disabilities than force them to do so. For employers it is important to have the state assistance in adjusting working place to the needs of employee with disabilities. Some tax benefits for employers having employees with disabilities also are seen as encouraging employment of persons with disabilities. Both employers and persons with disabilities believe that development of job coaching will help persons with disabilities to find and maintain a job at the open market. Majority of survey respondents think that the main reasons discouraging employment of persons with disabilities in Georgia are: poor socioeconomic background and high level of unemployment in the country, absence of related state programs and existed stigma towards persons with disabilities within the society. To conclude it can be said that both employers and persons with disabilities expect initiative from the government – development of the programs and services focusing on employment of persons with disabilities that will be rather encouraging and supporting than punishing and forcing. Relied on survey data it can be said that people have positive attitudes to see persons with disabilities at workplaces, educational institutions and public places. This creates a good background for extensive and consistent work towards social inclusion of persons with disabilities in Georgia.

Keywords: supported employment, job coaching, employment of persons with disabilities in Georgia, social inclusion

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474 Barriers to Business Model Innovation in the Agri-Food Industry

Authors: Pia Ulvenblad, Henrik Barth, Jennie Cederholm BjöRklund, Maya Hoveskog, Per-Ola Ulvenblad

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The importance of business model innovation (BMI) is widely recognized. This is also valid for firms in the agri-food industry, closely connected to global challenges. Worldwide food production will have to increase 70% by 2050 and the United Nations’ sustainable development goals prioritize research and innovation on food security and sustainable agriculture. The firms of the agri-food industry have opportunities to increase their competitive advantage through BMI. However, the process of BMI is complex and the implementation of new business models is associated with high degree of risk and failure. Thus, managers from all industries and scholars need to better understand how to address this complexity. Therefore, the research presented in this paper (i) explores different categories of barriers in research literature on business models in the agri-food industry, and (ii) illustrates categories of barriers with empirical cases. This study is addressing the rather limited understanding on barriers for BMI in the agri-food industry, through a systematic literature review (SLR) of 570 peer-reviewed journal articles that contained a combination of ‘BM’ or ‘BMI’ with agriculture-related and food-related terms (e.g. ‘agri-food sector’) published in the period 1990-2014. The study classifies the barriers in several categories and illustrates the identified barriers with ten empirical cases. Findings from the literature review show that barriers are mainly identified as outcomes. It can be assumed that a perceived barrier to growth can often be initially exaggerated or underestimated before being challenged by appropriate measures or courses of action. What may be considered by the public mind to be a barrier could in reality be very different from an actual barrier that needs to be challenged. One way of addressing barriers to growth is to define barriers according to their origin (internal/external) and nature (tangible/intangible). The framework encompasses barriers related to the firm (internal addressing in-house conditions) or to the industrial or national levels (external addressing environmental conditions). Tangible barriers can include asset shortages in the area of equipment or facilities, while human resources deficiencies or negative willingness towards growth are examples of intangible barriers. Our findings are consistent with previous research on barriers for BMI that has identified human factors barriers (individuals’ attitudes, histories, etc.); contextual barriers related to company and industry settings; and more abstract barriers (government regulations, value chain position, and weather). However, human factor barriers – and opportunities - related to family-owned businesses with idealistic values and attitudes and owning the real estate where the business is situated, are more frequent in the agri-food industry than other industries. This paper contributes by generating a classification of the barriers for BMI as well as illustrating them with empirical cases. We argue that internal barriers such as human factors barriers; values and attitudes are crucial to overcome in order to develop BMI. However, they can be as hard to overcome as for example institutional barriers such as governments’ regulations. Implications for research and practice are to focus on cognitive barriers and to develop the BMI capability of the owners and managers of agri-industry firms.

Keywords: agri-food, barriers, business model, innovation

Procedia PDF Downloads 228
473 Portable Environmental Parameter Monitor Based on STM32

Authors: Liang Zhao, Chongquan Zhong

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Introduction: According to statistics, people spend 80% to 90% of time indoor, so indoor air quality, either at home or in the office, greatly impacts the quality of life, health and work efficiency. Therefore, indoor air quality is very important to human activities. With the acceleration of urbanization, people are spending more time in indoor activity. The time in indoor environment, the living space, and the frequency interior decoration are all increasingly increased. However, housing decoration materials contain formaldehyde and other harmful substances, causing environmental and air quality problems, which have brought serious damage to countless families and attracted growing attention. According to World Health Organization statistics, the indoor environments in more than 30% of buildings in China are polluted by poisonous and harmful gases. Indoor pollution has caused various health problems, and these widespread public health problems can lead to respiratory diseases. Long-term inhalation of low-concentration formaldehyde would cause persistent headache, insomnia, weakness, palpitation, weight loss and vomiting, which are serious impacts on human health and safety. On the other hand, as for offices, some surveys show that good indoor air quality helps to enthuse the staff and improve the work efficiency by 2%-16%. Therefore, people need to further understand the living and working environments. There is a need for easy-to-use indoor environment monitoring instruments, with which users only have to power up and monitor the environmental parameters. The corresponding real-time data can be displayed on the screen for analysis. Environment monitoring should have the sensitive signal alarm function and send alarm when harmful gases such as formaldehyde, CO, SO2, are excessive to human body. System design: According to the monitoring requirements of various gases, temperature and humidity, we designed a portable, light, real-time and accurate monitor for various environmental parameters, including temperature, humidity, formaldehyde, methane, and CO. This monitor will generate an alarm signal when a target is beyond the standard. It can conveniently measure a variety of harmful gases and provide the alarm function. It also has the advantages of small volume, convenience to carry and use. It has a real-time display function, outputting the parameters on the LCD screen, and a real-time alarm function. Conclusions: This study is focused on the research and development of a portable parameter monitoring instrument for indoor environment. On the platform of an STM32 development board, the monitored data are collected through an external sensor. The STM32 platform is for data acquisition and processing procedures, and successfully monitors the real-time temperature, humidity, formaldehyde, CO, methane and other environmental parameters. Real-time data are displayed on the LCD screen. The system is stable and can be used in different indoor places such as family, hospital, and office. Meanwhile, the system adopts the idea of modular design and is superior in transplanting. The scheme is slightly modified and can be used similarly as the function of a monitoring system. This monitor has very high research and application values.

Keywords: indoor air quality, gas concentration detection, embedded system, sensor

Procedia PDF Downloads 251
472 Irradion: Portable Small Animal Imaging and Irradiation Unit

Authors: Josef Uher, Jana Boháčová, Richard Kadeřábek

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In this paper, we present a multi-robot imaging and irradiation research platform referred to as Irradion, with full capabilities of portable arbitrary path computed tomography (CT). Irradion is an imaging and irradiation unit entirely based on robotic arms for research on cancer treatment with ion beams on small animals (mice or rats). The platform comprises two subsystems that combine several imaging modalities, such as 2D X-ray imaging, CT, and particle tracking, with precise positioning of a small animal for imaging and irradiation. Computed Tomography: The CT subsystem of the Irradion platform is equipped with two 6-joint robotic arms that position a photon counting detector and an X-ray tube independently and freely around the scanned specimen and allow image acquisition utilizing computed tomography. Irradiation measures nearly all conventional 2D and 3D trajectories of X-ray imaging with precisely calibrated and repeatable geometrical accuracy leading to a spatial resolution of up to 50 µm. In addition, the photon counting detectors allow X-ray photon energy discrimination, which can suppress scattered radiation, thus improving image contrast. It can also measure absorption spectra and recognize different materials (tissue) types. X-ray video recording and real-time imaging options can be applied for studies of dynamic processes, including in vivo specimens. Moreover, Irradion opens the door to exploring new 2D and 3D X-ray imaging approaches. We demonstrate in this publication various novel scan trajectories and their benefits. Proton Imaging and Particle Tracking: The Irradion platform allows combining several imaging modules with any required number of robots. The proton tracking module comprises another two robots, each holding particle tracking detectors with position, energy, and time-sensitive sensors Timepix3. Timepix3 detectors can track particles entering and exiting the specimen and allow accurate guiding of photon/ion beams for irradiation. In addition, quantifying the energy losses before and after the specimen brings essential information for precise irradiation planning and verification. Work on the small animal research platform Irradion involved advanced software and hardware development that will offer researchers a novel way to investigate new approaches in (i) radiotherapy, (ii) spectral CT, (iii) arbitrary path CT, (iv) particle tracking. The robotic platform for imaging and radiation research developed for the project is an entirely new product on the market. Preclinical research systems with precision robotic irradiation with photon/ion beams combined with multimodality high-resolution imaging do not exist currently. The researched technology can potentially cause a significant leap forward compared to the current, first-generation primary devices.

Keywords: arbitrary path CT, robotic CT, modular, multi-robot, small animal imaging

Procedia PDF Downloads 85
471 Reaching Students Who “Don’t Like Writing” through Scenario Based Learning

Authors: Shahira Mahmoud Yacout

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Writing is an essential skill in many vocational, academic environments, and notably workplaces, yet many students perceive writing as being something tiring and boring or maybe a “waste of time”. Studies in the field of foreign languages related this fact might be due to the lack of connection between what is learned in the university and what students come to encounter in real life situations”. Arabic learners felt they needed more language exposure to the context of their future professions. With this idea in mind, Scenario based learning (SBL) is reported to be an educational approach to motivate, engage and stimulate students’ interest and to achieve the desired writing learning outcomes. In addition, researchers suggested Scenario based learning (SBL)as an instructional approach that develops and enhances students skills through developing higher order thinking skills and active learning. It is a subset of problem-based learning and case-based learning. The approach focuses on authentic rhetorical framing reflecting writing tasks in real life situations. It works successfully when used to simulate real-world practices, providing context that reflects the types of situations professionals respond to in writing. It was claimed that using realistic scenarios customized to the course’s learning objectives as it bridged the gap for students between theory and application. Within this context, it is thought that scenario-based learning is an important approach to enhance the learners’ writing skills and to reflect meaningful learning within authentic contexts. As an Arabicforeign language instructor, it was noticed that students find difficulties in adapting writing styles to authentic writing contexts and addressing different audiences and purposes. This idea is supported by studieswho claimed that AFL students faced difficulties with transferring writing skills to situations outside of the classroom context. In addition, it was observed that some of the Arabic textbooks for teaching Arabic as a foreign language lacked topics that initiated higher order thinking skills and stimulated the learners to understand the setting, and created messages appropriate to different audiences, context, and purposes. The goals of this study are to 1)provide a rational for using scenario-based learning approach to improveAFL learners in writing skills, 2) demonstrate how to design/ implement a scenario-based learning technique aligned with the writing course objectives,3) demonstrate samples of scenario-based approach implemented in AFL writing class, and 4)emphasis the role of peer-review along with the instructor’s feedback, in the process of developing the writing skill. Finally, this presentation highlighted and emphasized the importance of using the scenario-based learning approach in writing as a means to mirror students’ real-life situations and engage them in planning, monitoring, and problem solving. This approach helped in making writing an enjoyable experience and clearly useful to students’ future professional careers.

Keywords: meaningful learning, real life contexts, scenario based learning, writing skill

Procedia PDF Downloads 97
470 Assessment of Socio-Cultural Sustainability: A Comparative Analysis of Two Neighborhoods in Kolkata Metropolitan Area

Authors: Tanima Bhattacharya, Joy Sen

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To transform a space into a better livable and sustainable zone, United Nations Summit in New York 2015, has decided upon 17 sustainable development goals (SDGs) that approach directly to achieve inclusive, people-centric, sustainable developments. Though sustainability has been majorly constructed by four pillars, namely, Ecological, Economic, Social and Cultural, but it is essentially reduced to economic and ecological consideration in the context of developing countries. Therefore, in most cases planning has reduced its ambit to concentrate around the tangible infrastructure, ignoring the fundamentals of socio-cultural heritage. With the accentuating hype of infrastructural augmentation, lack of emphasis of traditional concerns like ethnicity and social connection have further diluted the situation, disintegrating cultural continuity. As cultural continuity lacks its cohesion, it’s growing absence increasingly acts as a catalyst to degrade the heritage structures, spaces around and linking these structures, and the ability of stakeholders in identifying themselves rooted in that particular space. Hence, this paper will argue that sustainability depends on the people and their interaction with their surroundings, their culture and livelihood. The interaction between people and their surroundings strengthen community building and social interaction that abides by stakeholders reverting back to their roots. To assess the socio-cultural sustainability of the city of Kolkata, two study areas are selected, namely, an old settlement from the northern part of the city of Kolkata (KMA), imbued with social connection, age-old cultural and ethnic bonding and, another cluster of new high-rises coming up in the Newtown area having portions of planned city extension on the eastern side of the city itself. Whereas, Newtown prioritizes the surging post-industrial trends of economic aspiration and ecological aspects of urban sustainability; the former settlements of northern Kolkata still continue to represent the earliest community settlement of the British-colonial-cum native era and even the pre-colonial era, permeated with socio-cultural reciprocation. Thus, to compare and assess the inlayed organizational structure of both the spaces in the two cases, selected areas have been surveyed to portray their current imageability. The argument of this paper is structured in 5parts. First, an introduction of the idea has been forwarded, Secondly, a literature review has been conducted to ground the proposed ideas, Thirdly, methodology has been discussed and appropriate case study areas have been selected, Fourthly, surveys and analyses has been forwarded and lastly, the paper has arrived at a set of conclusions by suggesting a threefold development to create happy, healthy and sustainable community.

Keywords: art innovation, current scenario assessment, heritage, imageability, socio-cultural sustainability

Procedia PDF Downloads 139
469 Transdisciplinary Methodological Innovation: Connecting Natural and Social Sciences Research through a Training Toolbox

Authors: Jessica M. Black

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Although much of natural and social science research aims to enhance human flourishing and address social problems, the training within the two fields is significantly different across theory, methodology, and implementation of results. Social scientists are trained in social, psychological, and to the extent that it is relevant to their discipline, spiritual development, theory, and accompanying methodologies. They tend not to receive training or learn about accompanying methodology related to interrogating human development and social problems from a biological perspective. On the other hand, those in the natural sciences, and for the purpose of this work, human biological sciences specifically – biology, neuroscience, genetics, epigenetics, and physiology – are often trained first to consider cellular development and related methodologies, and may not have opportunity to receive formal training in many of the foundational principles that guide human development, such as systems theory or person-in-environment framework, methodology related to tapping both proximal and distal psycho-social-spiritual influences on human development, and foundational principles of equity, justice and inclusion in research design. There is a need for disciplines heretofore siloed to know one another, to receive streamlined, easy to access training in theory and methods from one another and to learn how to build interdisciplinary teams that can speak and act upon a shared research language. Team science is more essential than ever, as are transdisciplinary approaches to training and research design. This study explores the use of a methodological toolbox that natural and social scientists can use by employing a decision-making tree regarding project aims, costs, and participants, among other important study variables. The decision tree begins with a decision about whether the researcher wants to learn more about social sciences approaches or biological approaches to study design. The toolbox and platform are flexible, such that users could also choose among modules, for instance, reviewing epigenetics or community-based participatory research even if those are aspects already a part of their home field. To start, both natural and social scientists would receive training on systems science, team science, transdisciplinary approaches, and translational science. Next, social scientists would receive training on grounding biological theory and the following methodological approaches and tools: physiology, (epi)genetics, non-invasive neuroimaging, invasive neuroimaging, endocrinology, and the gut-brain connection. Natural scientists would receive training on grounding social science theory, and measurement including variables, assessment and surveys on human development as related to the developing person (e.g., temperament and identity), microsystems (e.g., systems that directly interact with the person such as family and peers), mesosystems (e.g., systems that interact with one another but do not directly interact with the individual person, such as parent and teacher relationships with one another), exosystems (e.g., spaces and settings that may come back to affect the individual person, such as a parent’s work environment, but within which the individual does not directly interact, macrosystems (e.g., wider culture and policy), and the chronosystem (e.g., historical time, such as the generational impact of trauma). Participants will be able to engage with the toolbox and one another to foster increased transdisciplinary work

Keywords: methodology, natural science, social science, transdisciplinary

Procedia PDF Downloads 107
468 Disposal Behavior of Extreme Poor People Living in Guatemala at the Base of the Pyramid

Authors: Katharina Raab, Ralf Wagner

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With the decrease of poverty, the focus on the solid waste challenge shifts away from affluent, mostly Westernized consumers to the base of the pyramid. The relevance of considering the disposal behavior of impoverished people arises from improved welfare, leading to an increase in consumption opportunities and, consequently, of waste production. In combination with the world’s growing population the relevance of the topic increases, because solid waste management has global impacts on consumers’ welfare. The current annual municipal solid waste generation is estimated to 1.9 billion tonnes, 30% remains uncollected. As for the collected 70% is landfilling and dumping, 19% is recycled or recovered, 11% is led to energy recovery facilities. Therefore, aim is to contribute by adding first insights about poor people's disposal behaviors, including the framing of their rationalities, emotions and cognitions. The study provides novel empirical results obtained from qualitative semi-structured in-depth interviews near Guatemala City. In the study’s framework consumers have to choose from three options when deciding what to do with their obsolete possessions: Keeping the product: The main reason for this is the respondent´s emotional attachment to a product. Further, there is a willingness to use the same product under a different scope when it loses its functionality–they recycle their belongings in a customized and sustainable way. Permanently disposing of the product: The study reveals two dominant disposal methods: burning in front of their homes and throwing away in the physical environment. Respondents clearly recognized the disadvantages of burning toxic durables, like electronics. Giving a product away as a gift supports the integration of individuals in their peer networks of family and friends. Temporarily disposing of the product: Was not mentioned–to be specific, rent or lend a product to someone else was out of question. Contrasting the background to which extend poor people are aware of the consequences of their disposal decisions and how they feel about and rationalize their actions were quite unexpected. Respondents reported that they are worried about future consequences with impacts they cannot anticipate now–they are aware that their behaviors harm their health and the environment. Additionally, they expressed concern about the impact this disposal behavior would have on others’ well-being and are therefore sensitive to the waste that surrounds them. Concluding, the BoP-framed life and Westernized consumption, both fit in a circular economy pattern, but the nature of how to recycle and dispose separates these two societal groups. Both systems own a solid waste management system, but people living in slum-type districts and rural areas of poor countries are less interested in connecting to the system–they are primarily afraid of the costs. Further, it can be said that a consumer’s perceived effectiveness is distinct from environmental concerns, but contributes to forecasting certain pro-ecological behaviors. Considering the rationales underlying disposal decisions, thoughtfulness is a well-established determinant of disposition behavior. The precipitating events, emotions and decisions associated with the act of disposing of products are important because these decisions can trigger different results for the disposal process.

Keywords: base of the pyramid, disposal behavior, poor consumers, solid waste

Procedia PDF Downloads 169
467 Born in Limbo, Living in Limbo and Probably Will Die in Limbo

Authors: Betty Chiyangwa

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The subject of second-generation migrant youth is under-researched in the context of South Africa. Thus, their opinions and views have been marginalised in social science research. This paper addresses this gap by exploring the complexities of second-generation Mozambican migrant youth’s lived experiences in how they construct their identities and develop a sense of belonging in post-apartheid South Africa, specifically in Bushbuckridge. Bushbuckridge was among the earliest districts to accommodate Mozambican refugees to South Africa in the 1970s and remains associated with large numbers of Mozambicans. Drawing on Crenshaw’s (1989) intersectionality approach, the study contributes to knowledge on South-to-South migration by demonstrating how this approach is operationalised to understand the complex lived experiences of a disadvantaged group in life and possibly in death. In conceptualising the notion of identity among second-generation migrant youth, this paper explores the history and present of first and second-generation Mozambican migrants in South Africa to reveal how being born to migrant parents and raised in a hosting country poses life-long complications in one’s identity and sense of belonging. In the quest to form their identities and construct a sense of belonging, migrant youth employ precariously means to navigate the terrane. This is a case study informed by semi-structured interviews and narrative data gathered from 22 second-generation Mozambican migrant youth between 18 and 34 years who were born to at least one Mozambican parent living in Bushbuckridge and raised in South Africa. Views of two key informants from the South African Department of Home Affairs and the local tribal authority provided additional perspectives on second-generation migrant youth’s lived experiences in Bushbuckridge, which were explored thematically and narratively through Braun and Clarke’s (2012) six-step framework for analysing qualitative data. In exploring the interdependency and interconnectedness of social categories and social systems in Bushbuckridge, the findings revealed that participants’ experiences of identity formation and development of a sense of belonging were marginalised in complex, intersectional and precarious ways where they constantly (re)negotiated their daily experiences, which were largely shaped by their paradoxical migrant status in a host country. This study found that, in the quest for belonging, migrant youths were not a perfectly integrated category but evolved from almost daily lived experiences of creating a living that gave them an identity and a sense of belonging in South Africa. The majority of them shared feelings of living in limbo since childhood and fear of possibly dying in limbo with no clear (solid) sense of belonging to either South Africa or Mozambique. This study concludes that there is a strong association between feelings of identity, sense of belonging and levels of social integration. It recommends the development and adoption of a multilayer comprehensive model for understanding second-generation migrant youth identity and belonging in South Africa which encourages a collaborative effort among individual migrant youth, their family members, neighbours, society, and regional and national institutional structures for migrants to enhance and harness their capabilities and improve their wellbeing in South Africa.

Keywords: bushbuckridge, limbo, mozambican migrants, second-generation

Procedia PDF Downloads 66
466 Cities Under Pressure: Unraveling Urban Resilience Challenges

Authors: Sherine S. Aly, Fahd A. Hemeida, Mohamed A. Elshamy

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In the face of rapid urbanization and the myriad challenges posed by climate change, population growth, and socio-economic disparities, fostering urban resilience has become paramount. This abstract offers a comprehensive overview of the study on "Urban Resilience Challenges," exploring the background, methodologies, major findings, and concluding insights. The paper unveils a spectrum of challenges encompassing environmental stressors and deep-seated socio-economic issues, such as unequal access to resources and opportunities. Emphasizing their interconnected nature, the study underscores the imperative for holistic and integrated approaches to urban resilience, recognizing the intricate web of factors shaping the urban landscape. Urbanization has witnessed an unprecedented surge, transforming cities into dynamic and complex entities. With this growth, however, comes an array of challenges that threaten the sustainability and resilience of urban environments. This study seeks to unravel the multifaceted urban resilience challenges, exploring their origins and implications for contemporary cities. Cities serve as hubs of economic, social, and cultural activities, attracting diverse populations seeking opportunities and a higher quality of life. However, the urban fabric is increasingly strained by climate-related events, infrastructure vulnerabilities, and social inequalities. Understanding the nuances of these challenges is crucial for developing strategies that enhance urban resilience and ensure the longevity of cities as vibrant and adaptive entities. This paper endeavors to discern strategic guidelines for enhancing urban resilience amidst the dynamic challenges posed by rapid urbanization. The study aims to distill actionable insights that can inform strategic approaches. Guiding the formulation of effective strategies to fortify cities against multifaceted pressures. The study employs a multifaceted approach to dissect urban resilience challenges. A qualitative method will be employed, including comprehensive literature reviews and data analysis of urban vulnerabilities that provided valuable insights into the lived experiences of resilience challenges in diverse urban settings. In conclusion, this study underscores the urgency of addressing urban resilience challenges to ensure the sustained vitality of cities worldwide. The interconnected nature of these challenges necessitates a paradigm shift in urban planning and governance. By adopting holistic strategies that integrate environmental, social, and economic considerations, cities can navigate the complexities of the 21st century. The findings provide a roadmap for policymakers, planners, and communities to collaboratively forge resilient urban futures that withstand the challenges of an ever-evolving urban landscape.

Keywords: resilient principles, risk management, sustainable cities, urban resilience

Procedia PDF Downloads 51
465 Gradient Length Anomaly Analysis for Landslide Vulnerability Analysis of Upper Alaknanda River Basin, Uttarakhand Himalayas, India

Authors: Hasmithaa Neha, Atul Kumar Patidar, Girish Ch Kothyari

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The northward convergence of the Indian plate has a dominating influence over the structural and geomorphic development of the Himalayan region. The highly deformed and complex stratigraphy in the area arises from a confluence of exogenic and endogenetic geological processes. This region frequently experiences natural hazards such as debris flows, flash floods, avalanches, landslides, and earthquakes due to its harsh and steep topography and fragile rock formations. Therefore, remote sensing technique-based examination and real-time monitoring of tectonically sensitive regions may provide crucial early warnings and invaluable data for effective hazard mitigation strategies. In order to identify unusual changes in the river gradients, the current study demonstrates a spatial quantitative geomorphic analysis of the upper Alaknanda River basin, Uttarakhand Himalaya, India, using gradient length anomaly analysis (GLAA). This basin is highly vulnerable to ground creeping and landslides due to the presence of active faults/thrusts, toe-cutting of slopes for road widening, development of heavy engineering projects on the highly sheared bedrock, and periodic earthquakes. The intersecting joint sets developed in the bedrocks have formed wedges that have facilitated the recurrence of several landslides. The main objective of current research is to identify abnormal gradient lengths, indicating potential landslide-prone zones. High-resolution digital elevation data and geospatial techniques are used to perform this analysis. The results of GLAA are corroborated with the historical landslide events and ultimately used for the generation of landslide susceptibility maps of the current study area. The preliminary results indicate that approximately 3.97% of the basin is stable, while about 8.54% is classified as moderately stable and suitable for human habitation. However, roughly 19.89% fall within the zone of moderate vulnerability, 38.06% are classified as vulnerable, and 29% fall within the highly vulnerable zones, posing risks for geohazards, including landslides, glacial avalanches, and earthquakes. This research provides valuable insights into the spatial distribution of landslide-prone areas. It offers a basis for implementing proactive measures for landslide risk reduction, including land-use planning, early warning systems, and infrastructure development techniques.

Keywords: landslide vulnerability, geohazard, GLA, upper Alaknanda Basin, Uttarakhand Himalaya

Procedia PDF Downloads 68
464 Study on Health Status and Health Promotion Models for Prevention of Cardiovascular Disease in Asylum Seekers at Asylum Seekers Center, Kupang-Indonesia

Authors: Era Dorihi Kale, Sabina Gero, Uly Agustine

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Asylum seekers are people who come to other countries to get asylum. In line with that, they also carry the culture and health behavior of their country, which is very different from the new country they currently live in. This situation raises problems, also in the health sector. The approach taken must also be a culturally sensitive approach, where the culture and habits of the refugee's home area are also valued so that the health services provided can be right on target. Some risk factors that already exist in this group are lack of activity, consumption of fast food, smoking, and stress levels that are quite high. Overall this condition will increase the risk of an increased incidence of cardiovascular disease. This research is a descriptive and experimental study. The purpose of this study is to identify health status and develop a culturally sensitive health promotion model, especially related to the risk of cardiovascular disease for asylum seekers in detention homes in the city of Kupang. This research was carried out in 3 stages, stage 1 was conducting a survey of health problems and the risk of asylum seeker cardiovascular disease, Stage 2 developed a health promotion model, and stage 3 conducted a testing model of health promotion carried out. There were 81 respondents involved in this study. The variables measured were: health status, risk of cardiovascular disease and, health promotion models. Method of data collection: Instruments (questionnaires) were distributed to respondents answered for anamnese health status; then, cardiovascular risk measurements were taken. After that, the preparation of information needs and the compilation of booklets on the prevention of cardiovascular disease is carried out. The compiled booklet was then translated into Farsi. After that, the booklet was tested. Respondent characteristics: average lived in Indonesia for 4.38 years, the majority were male (90.1%), and most were aged 15-34 years (90.1%). There are several diseases that are often suffered by asylum seekers, namely: gastritis, headaches, diarrhea, acute respiratory infections, skin allergies, sore throat, cough, and depression. The level of risk for asylum seekers experiencing cardiovascular problems is 4 high risk people, 6 moderate risk people, and 71 low risk people. This condition needs special attention because the number of people at risk is quite high when compared to the age group of refugees. This is very related to the level of stress experienced by the refugees. The health promotion model that can be used is the transactional stress and coping model, using Persian (oral) and English for written information. It is recommended for health practitioners who care for refugees to always pay attention to aspects of culture (especially language) as well as the psychological condition of asylum seekers to make it easier to conduct health care and promotion. As well for further research, it is recommended to conduct research, especially relating to the effect of psychological stress on the risk of cardiovascular disease in asylum seekers.

Keywords: asylum seekers, health status, cardiovascular disease, health promotion

Procedia PDF Downloads 100
463 Design Flood Estimation in Satluj Basin-Challenges for Sunni Dam Hydro Electric Project, Himachal Pradesh-India

Authors: Navneet Kalia, Lalit Mohan Verma, Vinay Guleria

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Introduction: Design Flood studies are essential for effective planning and functioning of water resource projects. Design flood estimation for Sunni Dam Hydro Electric Project located in State of Himachal Pradesh, India, on the river Satluj, was a big challenge in view of the river flowing in the Himalayan region from Tibet to India, having a large catchment area of varying topography, climate, and vegetation. No Discharge data was available for the part of the river in Tibet, whereas, for India, it was available only at Khab, Rampur, and Luhri. The estimation of Design Flood using standard methods was not possible. This challenge was met using two different approaches for upper (snow-fed) and lower (rainfed) catchment using Flood Frequency Approach and Hydro-metrological approach. i) For catchment up to Khab Gauging site (Sub-Catchment, C1), Flood Frequency approach was used. Around 90% of the catchment area (46300 sqkm) up to Khab is snow-fed which lies above 4200m. In view of the predominant area being snow-fed area, 1 in 10000 years return period flood estimated using Flood Frequency analysis at Khab was considered as Probable Maximum Flood (PMF). The flood peaks were taken from daily observed discharges at Khab, which were increased by 10% to make them instantaneous. Design Flood of 4184 cumec thus obtained was considered as PMF at Khab. ii) For catchment between Khab and Sunni Dam (Sub-Catchment, C2), Hydro-metrological approach was used. This method is based upon the catchment response to the rainfall pattern observed (Probable Maximum Precipitation - PMP) in a particular catchment area. The design flood computation mainly involves the estimation of a design storm hyetograph and derivation of the catchment response function. A unit hydrograph is assumed to represent the response of the entire catchment area to a unit rainfall. The main advantage of the hydro-metrological approach is that it gives a complete flood hydrograph which allows us to make a realistic determination of its moderation effect while passing through a reservoir or a river reach. These studies were carried out to derive PMF for the catchment area between Khab and Sunni Dam site using a 1-day and 2-day PMP values of 232 and 416 cm respectively. The PMF so obtained was 12920.60 cumec. Final Result: As the Catchment area up to Sunni Dam has been divided into 2 sub-catchments, the Flood Hydrograph for the Catchment C1 has been routed through the connecting channel reach (River Satluj) using Muskingum method and accordingly, the Design Flood was computed after adding the routed flood ordinates with flood ordinates of catchment C2. The total Design Flood (i.e. 2-Day PMF) with a peak of 15473 cumec was obtained. Conclusion: Even though, several factors are relevant while deciding the method to be used for design flood estimation, data availability and the purpose of study are the most important factors. Since, generally, we cannot wait for the hydrological data of adequate quality and quantity to be available, flood estimation has to be done using whatever data is available. Depending upon the type of data available for a particular catchment, the method to be used is to be selected.

Keywords: design flood, design storm, flood frequency, PMF, PMP, unit hydrograph

Procedia PDF Downloads 322
462 Socio-Economic Insight of the Secondary Housing Market in Colombo Suburbs: Seller’s Point of Views

Authors: R. G. Ariyawansa, M. A. N. R. M. Perera

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“House” is a powerful symbol of socio-economic background of individuals and families. In fact, housing provides all types of needs/wants from basic needs to self-actualization needs. This phenomenon can be realized only having analyzed hidden motives of buyers and sellers of the housing market. Hence, the aim of this study is to examine the socio-economic insight of the secondary housing market in Colombo suburbs. This broader aim was achieved via analyzing the general pattern of the secondary housing market, identifying socio-economic motives of sellers of the secondary housing market, and reviewing sellers’ experience of buyer behavior. A purposive sample of 50 sellers from popular residential areas in Colombo such as Maharagama, Kottawa, Piliyandala, Punnipitiya, and Nugegoda was used to collect primary data instead of relevant secondary data from published and unpublished reports. The sample was limited to selling price ranging from Rs15 million to Rs25 million, which apparently falls into middle and upper-middle income houses in the context. Participatory observation and semi-structured interviews were adopted as key data collection tools. Data were descriptively analyzed. This study found that the market is mainly handled by informal agents who are unqualified and unorganized. People such as taxi/tree-wheel drivers, boutique venders, security personals etc. are engaged in housing brokerage as a part time career. Few fulltime and formally organized agents were found but they were also not professionally qualified. As far as housing quality is concerned, it was observed that 90% of houses was poorly maintained and illegally modified. They are situated in poorly maintained neighborhoods as well. Among the observed houses, 2% was moderately maintained and 8% was well maintained and modified. Major socio-economic motives of sellers were “migrating foreign countries for education and employment” (80% and 10% respectively), “family problems” (4%), and “social status” (3%). Other motives were “health” and “environmental/neighborhood problems” (3%). This study further noted that the secondary middle income housing market in the area directly related with the migrants who motivated for education in foreign countries, mainly Australia, UK and USA. As per the literature, families motivated for education tend to migrate Colombo suburbs from remote areas of the country. They are seeking temporary accommodation in lower middle income housing. However, the secondary middle income housing market relates with the migration from Colombo to major global cities. Therefore, final transaction price of this market may depend on migration related dates such as university deadlines, visa and other agreements. Hence, it creates a buyers’ market lowering the selling price. Also it was revealed that the buyers tend to trust more on this market as far as the quality of construction of houses is concerned than brand new houses which are built for selling purpose.

Keywords: informal housing market, hidden motives of buyers and sellers, secondary housing market, socio-economic insight

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461 Effect of Low to Moderate Altitude on Football Performance: An Analysis of Thirteen Seasons in the South African Premier Soccer League

Authors: Khatija Bahdur, Duane Dell’Oca

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There is limited information on how altitude impacts performance in a team sport. Most altitude research in football has been conducted at high elevation ( > 2500m), resulting in a chasm of understanding whether low to moderate altitude affects performance. The South African Premier Soccer League (PSL) fixtures entail matches played at altitudes from sea level to 1700m above mean sea level. Despite coaches highlighting the effect of altitude on performance outcomes in matches, further research is needed to establish whether altitude does impact match results. Greater insight into if and how altitude impacts performance in the PSL will assist coaches in deciding if and how to incorporate altitude in their planning. The purpose of this study is to fill in this gap through the use of a retrospective analysis of PSL matches. This quantitative study is based on a descriptive analysis of 181 PSL matches involving one team based at sea-level, taking place over a period of thirteen seasons. The following data were obtained: altitude at which the match was played, match result, the timing of goals, and timing of substitutions. The altitude was classified in 2 ways: inland ( > 500m) and coastal ( < 500m) and also further subdivided into narrower categories ( < 500m, 500-1000m, 1000-1300m; 1300-1500m, > 1500m). The analysis included a 2-sample t-test to determine differences in total goals scored and timing of goals for inland and coastal matches and the chi-square test to identify the significance of altitude on match results. The level of significance was set at the alpha level of 0.05. Match results are significantly affected by the altitude and level of altitude within inland teams most likely to win when playing at inland venues (p=0.000). The proportion of draws was slightly higher at the coast. At altitudes between 500-1000m, 1300-1500m, and 1500-1700m, a greater percentage of matches were won by coastal teams as opposed to draws. The timing of goals varied based on the team’s base altitude and the match elevation. The most significant differences were between 36-40 minutes (p=0.023), 41-45 minutes (p=0.000) and 50-65 minutes (p=0.000). When breaking down inland team’s matches to different altitude categories, greater differences were highlighted. Inland teams scored more goals per minute between 10-20 minute (p=0.009), 41-45 minutes (p=0.003) and 50-65 minutes (p=0.015). The total number of goals scored per match at different altitudes by a) inland teams (p=0.000), b) coastal teams (p=0.006). Coastal teams made significantly more substitutions when playing at altitude (p=0.034), although there were no significant differences when comparing the different altitude categories. The timing of all three changes, however, did vary significantly at the different altitudes. There were no significant differences in timing or number of substitutions for inland teams. Match results and timing of goals are influenced by altitude, with differences between the level of altitude also playing a role. The trends indicate that inland teams win more matches when playing at altitude against coastal teams, and they score more goals just prior to half-time and in the first quarter of the second half.

Keywords: coastal teams, inland teams, timing of goals, results, substitutions

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460 Advancing Food System Resilience by Pseudocereals Utilization

Authors: Yevheniia Varyvoda, Douglas Taren

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At the aggregate level, climate variability, the rising number of active violent conflicts, globalization and industrialization of agriculture, the loss in diversity of crop species, the increase in demand for agricultural production, and the adoption of healthy and sustainable dietary patterns are exacerbating factors of food system destabilization. The importance of pseudocereals to fuel and sustain resilient food systems is recognized by leading organizations working to end hunger, particularly for their critical capability to diversify livelihood portfolios and provide plant-sourced healthy nutrition in the face of systemic shocks and stresses. Amaranth, buckwheat, and quinoa are the most promising and used pseudocereals for ensuring food system resilience in the reality of climate change due to their high nutritional profile, good digestibility, palatability, medicinal value, abiotic stress tolerance, pest and disease resistance, rapid growth rate, adaptability to marginal and degraded lands, high genetic variability, low input requirements, and income generation capacity. The study provides the rationale and examples of advancing local and regional food systems' resilience by scaling up the utilization of amaranth, buckwheat, and quinoa along all components of food systems to architect indirect nutrition interventions and climate-smart approaches. Thus, this study aims to explore the drivers for ancient pseudocereal utilization, the potential resilience benefits that can be derived from using them, and the challenges and opportunities for pseudocereal utilization within the food system components. The PSALSAR framework regarding the method for conducting systematic review and meta-analysis for environmental science research was used to answer these research questions. Nevertheless, the utilization of pseudocereals has been slow for a number of reasons, namely the increased production of commercial and major staples such as maize, rice, wheat, soybean, and potato, the displacement due to pressure from imported crops, lack of knowledge about value-adding practices in food supply chain, limited technical knowledge and awareness about nutritional and health benefits, absence of marketing channels and limited access to extension services and information about resilient crops. The success of climate-resilient pathways based on pseudocereal utilization underlines the importance of co-designed activities that use modern technologies, high-value traditional knowledge of underutilized crops, and a strong acknowledgment of cultural norms to increase community-level economic and food system resilience.

Keywords: resilience, pseudocereals, food system, climate change

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459 Implications of Internationalization for Management and Practice in Higher Education

Authors: Naziema Begum Jappie

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The internationalization of higher education has become a focal point for academic institutions worldwide, including those in South Africa. This paper explores the multifaceted implications of internationalization on management and practice within the South African higher education landscape. Universities all over the world are increasingly recognizing the challenges of globalization and the pressures towards internationalization. Internationalization in higher education encompasses a range of activities, including academic exchange programs, research collaborations, joint degree programs, and the recruitment of international students and faculty. In South Africa, this process is driven by various factors, including the quest for global competitiveness, the pursuit of academic excellence, and the promotion of cultural diversity. However, while internationalization presents numerous opportunities, it also brings forth significant challenges that require careful consideration by management and practitioners in higher education institutions. Furthermore, the internationalization of higher education in South Africa has significant implications for teaching and learning practices. With an increasingly diverse student body, educators must employ innovative pedagogical approaches that cater to the needs and preferences of a multicultural cohort. This may involve the integration of global perspectives into the curriculum, the use of technology-enhanced learning platforms, and the promotion of intercultural competence among students and faculty. Additionally, the exchange of knowledge and ideas with international partners can enrich research activities and contribute to the advancement of knowledge in various fields. The internationalization of higher education in South Africa has profound implications for management and practice within academic institutions. While it offers opportunities for enhancing academic quality, promoting cultural exchange, and advancing research agendas, it also presents challenges that require strategic planning, resource allocation, and stakeholder engagement. By addressing these challenges proactively and leveraging the opportunities presented by internationalization, South African universities can position themselves as global leaders in higher education while contributing to the socio-economic development of the country and the continent at large. This paper draws together the international experience in South Africa to explore the emerging patterns of strategy and practice in internationalizing Higher Education and will highlight some critical notions of how the concepts of internationalization and globalization in the context of higher education are understood by those who lead universities and what new challenges are being created as universities seek to become more international. Institutions cannot simply have bullet points in the strategic plan for the recruitment of international students; there has to be a complete commitment to a national strategy of inclusivity. This paper will further examine the leadership styles that ensure transformation together with the goals set out for internationalization. Discussions around adding the international relations dimension to the curriculum. Addressing the issues relevant to cross-border delivery of higher education.

Keywords: challenges, higher education, internationalization, strategic focus

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458 Benefits of Rainbow School Programmes: Students' and Teachers' Perceptions and Attitudes Towards Gender-Fair Language in Gender-Inclusive Schools

Authors: Teresa Naves, Katy Pallas, Carme Florit, Cristina Anton, Joan Collado, Diana Millan

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Although gender-fair language is relatively novel in Spain, in Catalonia, the Department of Education, as well as LGBT Associations, have been promoting several innovative programmes aimed at implementing gender-inclusive schools. These Rainbow School communities are ideal for looking at how these programmes affect the use of gender-fair language and the balanced representation of gender. The students' and teachers' perceptions and attitudes have been compared to those analysed in schools that have never implemented such programmes in primary or secondary education. Spanish and Catalan, unlike English, are gendered languages in which masculine forms have traditionally been used as the unmarked gender and have been claimed to be inclusive of all genders. While the Royal Spanish Academy (RAE) rejects the use of inclusive language and thus deems all variables of inclusion of double gender as unnecessary, the vast majority of universities are promoting not only inclusive language but also gender-inclusive curricula. Adopting gender-fair language policies and including gender perspective in the curricula is an innovative trend at university level and in primary and secondary school education. Inclusion in education is a basic human right and the foundation for a more just and equal society. Educators can facilitate the process of welcoming by ensuring handbooks, forms, and other communications are inclusive of all family structures and gender identities. Using gendered language such as 'girls and boys' can be alienating for gender non-conforming and gender diverse students; on the other hand, non-gendered words like 'students' are regarded as inclusive of all identities. The paper discusses the results of mixed method research (survey, interviews, and experiment) conducted in Rainbow and non-Rainbow schools in Alacant and Barcelona (Spain). The experiment aimed at checking the role of gender-fair language in learners' perception of gender balance. It was conducted in Spanish, Catalan, and English. Students aged 10 to 16 (N > 600) were asked to draw pictures of people using specific prompts. The prompts in Spanish and Catalan were written using the generic masculine, 'los presidentes' 'els presidents' (presidents); using double gendered language such as 'ninos y ninas', 'nens i nenes' (boys and girls); and using non-gendered words like 'alumnado' 'alumnat' (students). The prompts were subdivided into people in school contexts participants could identify with, such as students and teachers; occupations mostly associated with men, such as pilots and firefighters; and occupations associated with women, such as ballet dancers and nurses. As could be expected, the participants only drew approximately the same percentage of female and male characters when double-gendered language or non-gendered words such as 'students' or 'teachers' were used, regardless of the language used in the experiment. When they were asked to draw people using the so-called generic masculine in Spanish or Catalan, 'los estudiantes' 'els estudiants' (students), less than 35% of the drawings contained female characters. The differences between the results for Rainbow and Non-Rainbow schools will be discussed in the light of the innovative coeducation programmes and learners' perceptions on gender-fair language gathered in the surveys and interviews.

Keywords: gender-fair language, gender-inclusive schools, learners’ and teachers’ perceptions and attitudes, rainbow coeducation programmes

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457 Training During Emergency Response to Build Resiliency in Water, Sanitation, and Hygiene

Authors: Lee Boudreau, Ash Kumar Khaitu, Laura A. S. MacDonald

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In April 2015, a magnitude 7.8 earthquake struck Nepal, killing, injuring, and displacing thousands of people. The earthquake also damaged water and sanitation service networks, leading to a high risk of diarrheal disease and the associated negative health impacts. In response to the disaster, the Environment and Public Health Organization (ENPHO), a Kathmandu-based non-governmental organization, worked with the Centre for Affordable Water and Sanitation Technology (CAWST), a Canadian education, training and consulting organization, to develop two training programs to educate volunteers on water, sanitation, and hygiene (WASH) needs. The first training program was intended for acute response, with the second focusing on longer term recovery. A key focus was to equip the volunteers with the knowledge and skills to formulate useful WASH advice in the unanticipated circumstances they would encounter when working in affected areas. Within the first two weeks of the disaster, a two-day acute response training was developed, which focused on enabling volunteers to educate those affected by the disaster about local WASH issues, their link to health, and their increased importance immediately following emergency situations. Between March and October 2015, a total of 19 training events took place, with over 470 volunteers trained. The trained volunteers distributed hygiene kits and liquid chlorine for household water treatment. They also facilitated health messaging and WASH awareness activities in affected communities. A three-day recovery phase training was also developed and has been delivered to volunteers in Nepal since October 2015. This training focused on WASH issues during the recovery and reconstruction phases. The interventions and recommendations in the recovery phase training focus on long-term WASH solutions, and so form a link between emergency relief strategies and long-term development goals. ENPHO has trained 226 volunteers during the recovery phase, with training ongoing as of April 2016. In the aftermath of the earthquake, ENPHO found that its existing pool of volunteers were more than willing to help those in their communities who were more in need. By training these and new volunteers, ENPHO was able to reach many more communities in the immediate aftermath of the disaster; together they reached 11 of the 14 earthquake-affected districts. The collaboration between ENPHO and CAWST in developing the training materials was a highly collaborative and iterative process, which enabled the training materials to be developed within a short response time. By training volunteers on basic WASH topics during both the immediate response and the recovery phase, ENPHO and CAWST have been able to link immediate emergency relief to long-term developmental goals. While the recovery phase training continues in Nepal, CAWST is planning to decontextualize the training used in both phases so that it can be applied to other emergency situations in the future. The training materials will become part of the open content materials available on CAWST’s WASH Resources website.

Keywords: water and sanitation, emergency response, education and training, building resilience

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456 Evaluation of Antibiotic Resistance and Extended-Spectrum β-Lactamases Production Rates of Gram Negative Rods in a University Research and Practice Hospital, 2012-2015

Authors: Recep Kesli, Cengiz Demir, Onur Turkyilmaz, Hayriye Tokay

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Objective: Gram-negative rods are a large group of bacteria, and include many families, genera, and species. Most clinical isolates belong to the family Enterobacteriaceae. Resistance due to the production of extended-spectrum β-lactamases (ESBLs) is a difficulty in the handling of Enterobacteriaceae infections, but other mechanisms of resistance are also emerging, leading to multidrug resistance and threatening to create panresistant species. We aimed in this study to evaluate resistance rates of Gram-negative rods bacteria isolated from clinical specimens in Microbiology Laboratory, Afyon Kocatepe University, ANS Research and Practice Hospital, between October 2012 and September 2015. Methods: The Gram-negative rods strains were identified by conventional methods and VITEK 2 automated identification system (bio-Mérieux, Marcy l’etoile, France). Antibiotic resistance tests were performed by both the Kirby-Bauer disk-diffusion and automated Antimicrobial Susceptibility Testing (AST, bio-Mérieux, Marcy l’etoile, France) methods. Disk diffusion results were evaluated according to the standards of Clinical and Laboratory Standards Institute (CLSI). Results: Of the totally isolated 1.701 Enterobacteriaceae strains 1434 (84,3%) were Klebsiella pneumoniae, 171 (10%) were Enterobacter spp., 96 (5.6%) were Proteus spp., and 639 Nonfermenting gram negatives, 477 (74.6%) were identified as Pseudomonas aeruginosa, 135 (21.1%) were Acinetobacter baumannii and 27 (4.3%) were Stenotrophomonas maltophilia. The ESBL positivity rate of the totally studied Enterobacteriaceae group were 30.4%. Antibiotic resistance rates for Klebsiella pneumoniae were as follows: amikacin 30.4%, gentamicin 40.1%, ampicillin-sulbactam 64.5%, cefepime 56.7%, cefoxitin 35.3%, ceftazidime 66.8%, ciprofloxacin 65.2%, ertapenem 22.8%, imipenem 20.5%, meropenem 20.5 %, and trimethoprim-sulfamethoxazole 50.1%, and for 114 Enterobacter spp were detected as; amikacin 26.3%, gentamicin 31.5%, cefepime 26.3%, ceftazidime 61.4%, ciprofloxacin 8.7%, ertapenem 8.7%, imipenem 12.2%, meropenem 12.2%, and trimethoprim-sulfamethoxazole 19.2 %. Resistance rates for Proteus spp. were: 24,3% meropenem, 26.2% imipenem, 20.2% amikacin 10.5% cefepim, 33.3% ciprofloxacin and levofloxacine, 31.6% ceftazidime, 20% ceftriaxone, 15.2% gentamicin, 26.6% amoxicillin-clavulanate, and 26.2% trimethoprim-sulfamethoxale. Resistance rates of P. aeruginosa was found as follows: Amikacin 32%, gentamicin 42 %, imipenem 43%, merpenem 43%, ciprofloxacin 50%, levofloxacin 52%, cefepim 38%, ceftazidim 63%, piperacillin/tacobactam 85%, for Acinetobacter baumannii; Amikacin 53.3%, gentamicin 56.6 %, imipenem 83%, merpenem 86%, ciprofloxacin 100%, ceftazidim 100%, piperacillin/tacobactam 85 %, colisitn 0 %, and for S. malthophilia; levofloxacin 66.6 % and trimethoprim/sulfamethoxozole 0 %. Conclusions: This study showed that resistance in Gram-negative rods was a serious clinical problem in our hospital and suggested the need to perform typification of the isolated bacteria with susceptibility testing regularly in the routine laboratory procedures. This application guided to empirical antibiotic treatment choices truly, as a consequence of the reality that each hospital shows different resistance profiles.

Keywords: antibiotic resistance, gram negative rods, ESBL, VITEK 2

Procedia PDF Downloads 328