Search results for: integrated safety promotion program
Commenced in January 2007
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Paper Count: 10177

Search results for: integrated safety promotion program

727 Immunomodulatory Role of Heat Killed Mycobacterium indicus pranii against Cervical Cancer

Authors: Priyanka Bhowmik, Subrata Majumdar, Debprasad Chattopadhyay

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Background: Cervical cancer is the third major cause of cancer in women and the second most frequent cause of cancer related deaths causing 300,000 deaths annually worldwide. Evasion of immune response by Human Papilloma Virus (HPV), the key contributing factor behind cancer and pre-cancerous lesions of the uterine cervix, makes immunotherapy a necessity to treat this disease. Objective: A Heat killed fraction of Mycobacterium indicus pranii (MIP), a non-pathogenic Mycobacterium has been shown to exhibit cytotoxic effects on different cancer cells, including human cervical carcinoma cell line HeLa. However, the underlying mechanisms remain unknown. The aim of this study is to decipher the mechanism of MIP induced HeLa cell death. Methods: The cytotoxicity of Mycobacterium indicus pranii against HeLa cells was evaluated by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Apoptosis was detected by annexin V and Propidium iodide (PI) staining. The assessment of reactive oxygen species (ROS) generation and cell cycle analysis were measured by flow cytometry. The expression of apoptosis associated genes was analyzed by real time PCR. Result: MIP could inhibit the proliferation of HeLa cell in a time and dose dependent manner but caused minor damage to normal cells. The induction of apoptosis was confirmed by the cell surface presentation of phosphatidyl serine, DNA fragmentation, and mitochondrial damage. MIP caused very early (as early as 30 minutes) transcriptional activation of p53, followed by a higher activation (32 fold) at 24 hours suggesting prime importance of p53 in MIP-induced apoptosis in HeLa cell. The up regulation of p53 dependent pro-apoptotic genes Bax, Bak, PUMA, and Noxa followed a lag phase that was required for the transcriptional p53 program. MIP also caused the transcriptional up regulation of Toll like receptor 2 and 4 after 30 minutes of MIP treatment suggesting recognition of MIP by toll like receptors. Moreover, MIP caused the inhibition of expression of HPV anti apoptotic gene E6, which is known to interfere with p53/PUMA/Bax apoptotic cascade. This inhibition might have played a role in transcriptional up regulation of PUMA and subsequently apoptosis. ROS was generated transiently which was concomitant with the highest transcription activation of p53 suggesting a plausible feedback loop network of p53 and ROS in the apoptosis of HeLa cells. Scavenger of ROS, such as N-acetyl-L-cysteine, decreased apoptosis suggesting ROS is an important effector of MIP induced apoptosis. Conclusion: Taken together, MIP possesses full potential to be a novel therapeutic agent in the clinical treatment of cervical cancer.

Keywords: cancer, mycobacterium, immunity, immunotherapy.

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726 Combained Cultivation of Endemic Strains of Lactic Acid Bacteria and Yeast with Antimicrobial Properties

Authors: A. M. Isakhanyan, F. N. Tkhruni, N. N. Yakimovich, Z. I. Kuvaeva, T. V. Khachatryan

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Introduction: At present, the simbiotics based on different genera and species of lactic acid bacteria (LAB) and yeasts are used. One of the basic properties of probiotics is presence of antimicrobial activity and therefore selection of LAB and yeast strains for their co-cultivation with the aim of increasing of the activity is topical. Since probiotic yeast and bacteria have different mechanisms of action, natural synergies between species, higher viability and increasing of antimicrobial activity might be expected from mixing both types of probiotics. Endemic strains of LAB Enterococcus faecium БТK-64, Lactobaccilus plantarum БТK-66, Pediococcus pentosus БТK-28, Lactobacillus rhamnosus БТK-109 and Kluyveromyces lactis БТX-412, Saccharomycopsis sp. БТX- 151 strains of yeast, with probiotic properties and hight antimicrobial activity, were selected. Strains are deposited in "Microbial Depository Center" (MDC) SPC "Armbiotechnology". Methods: LAB and yeast strains were isolated from different dairy products from rural households of Armenia. The genotyping by 16S rRNA sequencing for LAB and 26S RNA sequencing for yeast were used. Combined cultivation of LAB and yeast strains was carried out in the nutrient media on the basis of milk whey, in anaerobic conditions (without shaker, in a thermostat at 37oC, 48 hours). The complex preparations were obtained by purification of cell free culture broth (CFC) broth by the combination of ion-exchange chromatography and gel filtration methods. The spot-on-lawn method was applied for determination of antimicrobial activity and expressed in arbitrary units (AU/ml). Results. The obtained data showed that at the combined growth of bacteria and yeasts, the cultivation conditions (medium composition, time of growth, genera of LAB and yeasts) affected the display of antimicrobial activity. Purification of CFC broth allowed obtaining partially purified antimicrobial complex preparation which contains metabiotics from both bacteria and yeast. The complex preparation inhibited the growth of pathogenic and conditionally pathogenic bacteria, isolated from various internal organs from diseased animals and poultry with greater efficiency than the preparations derived individually alone from yeast and LAB strains. Discussion. Thus, our data shown perspectives of creation of a new class of antimicrobial preparations on the basis of combined cultivation of endemic strains of LAB and yeast. Obtained results suggest the prospect of use of the partially purified complex preparations instead antibiotics in the agriculture and for food safety. Acknowledgments: This work was supported by the RA MES State Committee of Science and Belarus National Foundation for Basic Research in the frames of the joint Armenian - Belarusian joint research project 13РБ-064.

Keywords: co-cultivation, antimicrobial activity, biosafety, metabiotics, lactic acid bacteria, yeast

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725 Social Value of Travel Time Savings in Sub-Saharan Africa

Authors: Richard Sogah

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The significance of transport infrastructure investments for economic growth and development has been central to the World Bank’s strategy for poverty reduction. Among the conventional surface transport infrastructures, road infrastructure is significant in facilitating the movement of human capital goods and services. When transport projects (i.e., roads, super-highways) are implemented, they come along with some negative social values (costs), such as increased noise and air pollution for local residents living near these facilities, displaced individuals, etc. However, these projects also facilitate better utilization of existing capital stock and generate other observable benefits that can be easily quantified. For example, the improvement or construction of roads creates employment, stimulates revenue generation (toll), reduces vehicle operating costs and accidents, increases accessibility, trade expansion, safety improvement, etc. Aside from these benefits, travel time savings (TTSs) which are the major economic benefits of urban and inter-urban transport projects and therefore integral in the economic assessment of transport projects, are often overlooked and omitted when estimating the benefits of transport projects, especially in developing countries. The absence of current and reliable domestic travel data and the inability of replicated models from the developed world to capture the actual value of travel time savings due to the large unemployment, underemployment, and other labor-induced distortions has contributed to the failure to assign value to travel time savings when estimating the benefits of transport schemes in developing countries. This omission of the value of travel time savings from the benefits of transport projects in developing countries poses problems for investors and stakeholders to either accept or dismiss projects based on schemes that favor reduced vehicular operating costs and other parameters rather than those that ease congestion, increase average speed, facilitate walking and handloading, and thus save travel time. Given the complex reality in the estimation of the value of travel time savings and the presence of widespread informal labour activities in Sub-Saharan Africa, we construct a “nationally ranked distribution of time values” and estimate the value of travel time savings based on the area beneath the distribution. Compared with other approaches, our method captures both formal sector workers and individuals/people who work outside the formal sector and hence changes in their time allocation occur in the informal economy and household production activities. The dataset for the estimations is sourced from the World Bank, the International Labour Organization, etc.

Keywords: road infrastructure, transport projects, travel time savings, congestion, Sub-Sahara Africa

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724 From Stigma to Solutions: Harnessing Innovation and Local Wisdom to Tackle Harms Associated with Menstrual Seclusion (Chhaupadi) in Nepal

Authors: Sara E. Baumann, Megan A. Rabin, Mary Hawk, Bhimsen Devkota, Kajol Upadhyaya, Guna Raj Shrestha, Brigit Joseph, Annika Agarwal, Jessica G. Burke

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In Nepal, prevailing sociocultural norms associated with menstruation prompt adherence to stringent rules that limit participation in daily activities. Chhaupadi is a specific menstrual tradition in Nepal in which women and girls segregate themselves and follow a series of restrictions during menstruation. Despite having numerous physical and mental health implications, extant interventions have yet to sustainably address the harms associated with chhaupadi. In this study, the authors describe insights garnered from a collaboration with community members in Dailekh district, who formulated their own approaches to mitigate the adverse facets of chhaupadi. Envisaged as an entry point to improve women’s menstrual health experiences, this investigation employed an approach that uses Human-centered Design and a community-engaged approach. The authors conducted a four-day design workshop which unfolded in two phases: The Discovery Phase, to uncover chhaupadi context and key stakeholders, and the Design Phase, to design contextually relevant interventions. Diverse community-members, including those with lived experience practicing chhaupadi, developed five intervention concepts: 1) harnessing Female Community Health Volunteers as role models, for counseling, and raising awareness; 2) focusing on mothers and mother’s groups to instigate behavioral shifts; 3) engaging the broader community in behavior change efforts; 4) empowering fathers to effect change in their homes through counseling and education; and 5) training and emboldening youth to advocate for positive change through advocacy in their schools and homes. This research underscores the importance of employing multi-level approaches tailored to specific stakeholder groups, given Nepal’s rich cultural diversity. The engagement of Female Community Health Volunteers emerged as a promising yet underexplored intervention concept for chhaupadi, warranting broader implementation. Crucially, it is also imperative for interventions to prioritize tackling deleterious aspects of the chhaupadi tradition, emphasizing safety considerations, all while acknowledging chhaupadi’s entrenched cultural history; for some, there are positive aspects of the tradition that women and girls wish to preserve.

Keywords: human-centered design, menstrual health, Nepal, community-engagement, intervention development, women's health, rural health

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723 Measuring the Impact of Implementing an Effective Practice Skills Training Model in Youth Detention

Authors: Phillipa Evans, Christopher Trotter

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Aims: This study aims to examine the effectiveness of a practice skills framework implemented in three youth detention centres in Juvenile Justice in New South Wales (NSW), Australia. The study is supported by a grant from and Australian Research Council and NSW Juvenile Justice. Recent years have seen a number of incidents in youth detention centres in Australia and other places. These have led to inquiries and reviews with some suggesting that detention centres often do not even meet basic human rights and do little in terms of providing opportunities for rehabilitation of residents. While there is an increasing body of research suggesting that community based supervision can be effective in reducing recidivism if appropriate skills are used by supervisors, there has been less work considering worker skills in youth detention settings. The research that has been done, however, suggest that teaching interpersonal skills to youth officers may be effective in enhancing the rehabilitation culture of centres. Positive outcomes have been seen in a UK detention centre for example, from teaching staff to do five-minute problem-solving interventions. The aim of this project is to examine the effectiveness of training and coaching youth detention staff in three NSW detention centres in interpersonal practice skills. Effectiveness is defined in terms of reductions in the frequency of critical incidents and improvements in the well-being of staff and young people. The research is important as the results may lead to the development of more humane and rehabilitative experiences for young people. Method: The study involves training staff in core effective practice skills and supporting staff in the use of those skills through supervision and de-briefing. The core effective practice skills include role clarification, pro-social modelling, brief problem solving, and relationship skills. The training also addresses some of the background to criminal behaviour including trauma. Data regarding critical incidents and well-being before and after the program implementation are being collected. This involves interviews with staff and young people, the completion of well-being scales, and examination of departmental records regarding critical incidents. In addition to the before and after comparison a matched control group which is not offered the intervention is also being used. The study includes more than 400 young people and 100 youth officers across 6 centres including the control sites. Data collection includes interviews with workers and young people, critical incident data such as assaults, use of lock ups and confinement and school attendance. Data collection also includes analysing video-tapes of centre activities for changes in the use of staff skills. Results: The project is currently underway with ongoing training and supervision. Early results will be available for the conference.

Keywords: custody, practice skills, training, youth workers

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722 Co-Creation of Content with the Students in Entrepreneurship Education to Capture Entrepreneurship Phenomenon in an Innovative Way

Authors: Prema Basargekar

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Facilitating the subject ‘Entrepreneurship Education’ in higher education, such as management studies, can be exhilarating as well as challenging. It is a multi-disciplinary and ever-evolving subject. Capturing entrepreneurship as a phenomenon in a holistic manner is a daunting task as it requires covering various dimensions such as new ideas generation, entrepreneurial traits, business opportunities scanning, the role of policymakers, value creation, etc., to name a few. Implicit entrepreneurship theory and effectuation are two different theories that focus on engaging the participants to create content by using their own experiences, perceptions, and belief systems. It helps in understanding the phenomenon holistically. The assumption here is that all of us are part of the entrepreneurial ecosystem, and effective learning can come through active engagement and peer learning by all the participants together. The present study is an attempt to use these theories in the class assignment given to the students at the beginning of the course to build the course content and understand entrepreneurship as a phenomenon in a better way through peer learning. The assignment was given to three batches of MBA post-graduate students doing the program in one of the private business schools in India. The subject of ‘Entrepreneurship Management’ is facilitated in the third trimester of the first year. At the beginning of the course, the students were given the assignment to submit a brief write-up/ collage/picture/poem or in any other format about “What entrepreneurship means to you?” They were asked to give their candid opinions about entrepreneurship as a phenomenon as they perceive it. Nearly 156 students doing post-graduate MBA submitted the assignment. These assignments were further used to find answers to two research questions. – 1) Are students able to use divergent and innovative forms to express their opinions, such as poetry, illustrations, videos, etc.? 2) What are various dimensions of entrepreneurship which are emerging to understand the phenomenon in a better way? The study uses the Brawn and Clark framework of reflective thematic analysis for qualitative analysis. The study finds that students responded to this assignment enthusiastically and expressed their thoughts in multiple ways, such as poetry, illustration, personal narrative, videos, etc. The content analysis revealed that there could be seven dimensions to looking at entrepreneurship as a phenomenon. They are 1) entrepreneurial traits, 2) entrepreneurship as a journey, 3) value creation by entrepreneurs in terms of economic and social value, 4) entrepreneurial role models, 5) new business ideas and innovations, 6) personal entrepreneurial experiences and aspirations, and 7) entrepreneurial ecosystem. The study concludes that an implicit approach to facilitate entrepreneurship education helps in understanding it as a live phenomenon. It also encourages students to apply divergent and convergent thinking. It also helps in triggering new business ideas or stimulating the entrepreneurial aspirations of the students. The significance of the study lies in the application of implicit theories in the classroom to make higher education more engaging and effective.

Keywords: co-creation of content, divergent thinking, entrepreneurship education, implicit theory

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721 Associated Problems with the Open Dump Site and Its Possible Solutions

Authors: Pangkaj Kumar Mahanta, Md. Rafizul Islam

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The rapid growth of the population causes a substantial amount of increase in household waste all over the world. Waste management is becoming one of the most challenging phenomena in the present day. The most environmentally friendly final disposal process of waste is sanitary landfilling, which is practiced in most developing countries. However, in Southeast Asia, most of the final disposal point is an open dump site. Due to the ignominy of proper management of waste and monitoring, the surrounding environment gets polluted more by the open dump site in comparison with a sanitary landfill. Khulna is 3rd largest metropolitan city in Bangladesh, having a population of around 1.5 million and producing approximately 450 tons per day of Municipal Solid Waste. The Municipal solid waste of Khulna city is disposed of in Rajbandh open dump site. The surrounding air is being polluted by the gas produced in the open dump site. Also, the open dump site produces leachate, which contains various heavy metals like Cadmium (Cd), Chromium (Cr), Lead (Pb), Manganese (Mn), Mercury (Hg), Strontium (Sr), etc. Leachate pollutes the soil as well as the groundwater of the open dump site and also the surrounding area through seepage. Moreover, during the rainy season, the surface water is polluted by leachate runoff. Also, the plastic waste flowing out from the open dump site through various drivers pollutes the nearby environment. The health risk assessment associated with heavy metals was carried out by computing the chronic daily intake (CDI), hazard quotient (HQ), and hazard index (HI) via different exposure pathways following the USEPA guidelines. For ecological risk, potential contamination index (Cp), Contamination factor (CF), contamination load index (PLI), numerical integrated contamination factor (NICF), enrichment factor (EF), ecological risk index (ER), and potential ecological risk index (PERI) were computed. The health risk and ecological risk assessment results reveal that some heavy metals possess strong health and ecological risk. In addition, the child faces higher harmful health risks from several heavy metals than the adult for all the exposure pathways and media. The conversion of an open dump site into a sanitary landfill and a proper management system can reduce the problems associated with an open dump site. In the sanitary landfill, the produced gas will be managed properly to save the surrounding atmosphere from being polluted. The seepage of leachate can be minimized by installing a compacted clay layer (CCL) as a baseline and leachate collection in a sanitary landfill to save the underlying soil layer and surrounding water bodies from leachate. Another important component of a sanitary landfill is the conversion of plastic waste to energy will minimize the plastic pollution in the landfill area and also the surrounding soil and water bodies. Also, in the sanitary landfill, the bio-waste can be used to make compost to reduce the volume of bio-waste and proper utilization of the landfill area.

Keywords: ecological risk, health risk, open dump site, sanitary landfill

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720 Infant and Young Child Dietary Diversification Using Locally Available Foods after Nutrition Education in Rural Malawi

Authors: G. C. Phiri, E. A. Heil, A. A. Kalimbira, E. Muehlhoff, C. Masangano, B. M. Mtimuni, J. Herrmann, M. B. Krawinkel, I. Jordan

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Background and objectives: High prevalence of undernutrition in Malawi is caused by poor complementary foods. Lack of knowledge of age appropriate food within the household might affect utilization of available resources. FAO-Malawi implemented nutrition education (NE) sessions in 200 villages in Kasungu and Mzimba districts from December 2012 to April 2013 targeting 15 caregivers per village of children aged 6-18 months, grandmothers, spouses and community leaders. Two trained volunteers per village facilitated 10 NE sessions on breastfeeding, food safety and hygiene and complementary feeding using locally available resources. This study assessed the reported dietary diversification practices of infant and young child after nutrition education and the factors that influenced adoption of the practice. Methodology: Questionnaire-based interviews with caregivers were conducted in 16 randomly selected villages (n=108) before training-(t1) and seven months after training-(t2). Knowledge score (KS) was calculated on the indicators breastfeeding, hygiene and complementary feeding. Count regression was performed using SPSS 22. Eight focus group discussions (FGDs) were separately conducted among caregivers and grandmothers in 4 villages. Content analysis was used to analyze FGDs data. Results: Following NE, caregivers' KS significantly increased (p<0.001) between t1 and t2 for breastfeeding (7.7 vs. 9.8, max=18), hygiene (3.8 vs. 5.9, max=7) and complementary feeding (10.2 vs. 16.2, max=26). Caregivers indicated that they stopped preparation of plain-refined maize meal porridge after they gained knowledge on dietary diversification of complementary foods. They learnt mushing and pounding of ingredients for enriched porridge. Whole-maize meal or potatoes were often enriched with vegetables, legumes, small fish or eggs and cooking oil. Children liked the taste of enriched porridge. Amount of enriched porridge consumed at each sitting increase among previously fussy-eater children. Meal frequency increased by including fruits as snacks in child’s diet. Grandmothers observed preparation of enriched porridge among the mothers using locally available foods. Grandmothers liked the taste of enriched porridge and not the greenish color of the porridge. Both grandmothers and mothers reported that children were playing independently after consuming enriched porridge and were strong and healthy. These motivated adoption of the practice. Conclusion: Increased knowledge and skill of preparation and utilisation of locally available foods promoted children’s dietary diversification. Children liking the enriched porridge motivated adoption of dietary diversification.

Keywords: behaviour change, complementary feeding, dietary diversification, IYCN

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719 Development and Psychometric Properties of the Dutch Contextual Assessment of Social Skills: A Blinded Observational Outcome Measure of Social Skills for Adolescents with Autism Spectrum Disorder

Authors: Sakinah Idris, Femke Ten Hoeve, Kirstin Greaves-Lord

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Background: Social skills interventions are considered to be efficacious if social skills are improved as a result of an intervention. Nevertheless, the objective assessment of social skills is hindered by a lack of sensitive and validated measures. To measure the change in social skills after an intervention, questionnaires reported by parents, clinicians and/or teachers are commonly used. Observations are the most ecologically valid method of assessing improvements in social skills after an intervention. For this purpose, The Program for the Educational and Enrichment of Relational Skills (PEERS) was developed for adolescents, in order to teach them the age-appropriate skills needed to participate in society. It is an evidence-based intervention for adolescents with ASD that taught ecologically valid social skills techniques. Objectives: The current study aims to describe the development and psychometric evaluation of the Dutch Contextual Assessment of Social Skills (CASS), an observational outcome measure of social skills for adolescents with Autism Spectrum Disorder (ASD). Methods: 64 adolescents (M = 14.68, SD = 1.41, 71% boys) with ASD performed the CASS before and after a social skills intervention (i.e. PEERS or the active control condition). Each adolescent completed a 3-minute conversation with a confederate. The conversation was prompt as a natural introduction between two-unfamiliar, similar ages, opposite-sex peers who meet for the first time. The adolescent and the confederate completed a brief questionnaire about the conversation (Conversation Rating Scale). Results: Results indicated sufficient psychometric properties. The Dutch CASS has a high level of internal consistency (Cronbach's α coefficients = 0.84). Data supported the convergent validity (i.e., significant correlated with the Social Skills Improvement System (SSiS). The Dutch CASS did not significantly correlate with the autistic mannerism subscale from Social Responsiveness Scale (SRS), thus proved the divergent validity. Based on scorings made by raters who were kept blind to the time points, reliable change index was computed to assess the change in social skills. With regard to the content validity, only the learning objectives of the first two meetings of PEERS about conversational skills relatively matched with rating domains of the CASS. Due to this underrepresentation, we found an existing observational measure (TOPICC) that covers some of the other learning objectives of PEERS. TOPICC covers 22% of the learning objectives of PEERS about conversational skills, meanwhile, CASS is 45%. Unfortunately, 33% of the learning objectives of PEERS was not covered by CASS or TOPICC. Conclusion: Recommendations are made to improve the psychometric properties and content validity of the Dutch CASS.

Keywords: autism spectrum disorder, observational, PEERS, social skills

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718 The Relationship between Wasting and Stunting in Young Children: A Systematic Review

Authors: Susan Thurstans, Natalie Sessions, Carmel Dolan, Kate Sadler, Bernardette Cichon, Shelia Isanaka, Dominique Roberfroid, Heather Stobagh, Patrick Webb, Tanya Khara

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For many years, wasting and stunting have been viewed as separate conditions without clear evidence supporting this distinction. In 2014, the Emergency Nutrition Network (ENN) examined the relationship between wasting and stunting and published a report highlighting the evidence for linkages between the two forms of undernutrition. This systematic review aimed to update the evidence generated since this 2014 report to better understand the implications for improving child nutrition, health and survival. Following PRISMA guidelines, this review was conducted using search terms to describe the relationship between wasting and stunting. Studies related to children under five from low- and middle-income countries that assessed both ponderal growth/wasting and linear growth/stunting, as well as the association between the two, were included. Risk of bias was assessed in all included studies using SIGN checklists. 45 studies met the inclusion criteria- 39 peer reviewed studies, 1 manual chapter, 3 pre-print publications and 2 published reports. The review found that there is a strong association between the two conditions whereby episodes of wasting contribute to stunting and, to a lesser extent, stunting leads to wasting. Possible interconnected physiological processes and common risk factors drive an accumulation of vulnerabilities. Peak incidence of both wasting and stunting was found to be between birth and three months. A significant proportion of children experience concurrent wasting and stunting- Country level data suggests that up to 8% of children under 5 may be both wasted and stunted at the same time, global estimates translate to around 16 million children. Children with concurrent wasting and stunting have an elevated risk of mortality when compared to children with one deficit alone. These children should therefore be considered a high-risk group in the targeting of treatment. Wasting, stunting and concurrent wasting and stunting appear to be more prevalent in boys than girls and it appears that concurrent wasting and stunting peaks between 12- 30 months of age with younger children being the most affected. Seasonal patterns in prevalence of both wasting and stunting are seen in longitudinal and cross sectional data and in particular season of birth has been shown to have an impact on a child’s subsequent experience of wasting and stunting. Evidence suggests that the use of mid-upper-arm circumference combined with weight-for-age Z-score might effectively identify children most at risk of near-term mortality, including those concurrently wasted and stunted. Wasting and stunting frequently occur in the same child, either simultaneously or at different moments through their life course. Evidence suggests there is a process of accumulation of nutritional deficits and therefore risk over the life course of a child demonstrates the need for a more integrated approach to prevention and treatment strategies to interrupt this process. To achieve this, undernutrition policies, programmes, financing and research must become more unified.

Keywords: Concurrent wasting and stunting, Review, Risk factors, Undernutrition

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717 The Incorporation of Themes Related to Islandness in Tourism Branding among Cold-Water, Warm-Water, and Temperate-Water Islands

Authors: Susan C. Graham

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Islands have a long established allure for travellers the world over. From earliest accounts of human history, travellers were drawn by the sense of islandness embodied by these destinations. The concept of islandness describes the essence of what makes islands unique relative to non-islands and extends beyond geographic interpretations by attempting to capture the specific sense of self-exhibited by islanders in relation to their connection to place. The themes most strongly associated with islandness include a) a strong connection to water as both the life blood and a physical barrier, b) a unique culture and robust arts community that is deeply linked to both the island and islanders, c) an appreciation of and for nature, d) a rich sense of history and tradition connected to the place, e) a sense of community and belonging that arose through shared triumphs and struggles, and f) a profound awareness of independence, separateness, and uniqueness derived from both physical and social experience. The island brand, like all brands, is a marketing tactic designed to succinctly express a specific value proposition in simplistic ways which might include a brand symbol, logo, slogan, or representation meant to distinguish one brand from another. If a value proposition is the identification of attributes that separate one brand from another by highlighting the brand’s uniqueness, then presumably island brands may, at least in part, emphasize islandness as part of the destination brand. Yet it may in naïve to expect all islands to brand themselves using similar themes when islands can differ so substantially in terms of population, geography, political climate, economy, culture, and history. Of particular interest is the increased focus on tourism among 'cold-water' islands. This paper will examine the incorporation of themes related to islandness in tourism branding among cold-water, warm-water, and temperate-water islands. The tourism logos of 83 islands were collected and assessed for the use of themes related to islandness, namely water, arts and culture, nature, history and tradition, community and belongingness, and independence, separateness, and uniqueness. The ratings for each theme related to islandness for each of the 83 island destinations were then analyzed to identify if differences exist between cold-water, warm-water, and temperate-water islands. A general consensus of what constitutes 'cold-water' destinations is lacking, therefore a water temperature of 15C was adopted using the guidelines from the National Center for Cold Water Safety. Among these 83 islands, the average high and average low water temperatures of 196 specific locations, including the capital, northern, and southern most points of each island, was recorded to determine if the location was a cold-water (average high and low below 15C), warm-water (average high and low above 15C), or temperate-water (average high above 15C and low below 15C) location.

Keywords: branding, cold-water, islands, tourism

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716 Measurement of Magnetic Properties of Grainoriented Electrical Steels at Low and High Fields Using a Novel Single

Authors: Nkwachukwu Chukwuchekwa, Joy Ulumma Chukwuchekwa

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Magnetic characteristics of grain-oriented electrical steel (GOES) are usually measured at high flux densities suitable for its typical applications in power transformers. There are limited magnetic data at low flux densities which are relevant for the characterization of GOES for applications in metering instrument transformers and low frequency magnetic shielding in magnetic resonance imaging medical scanners. Magnetic properties such as coercivity, B-H loop, AC relative permeability and specific power loss of conventional grain oriented (CGO) and high permeability grain oriented (HGO) electrical steels were measured and compared at high and low flux densities at power magnetising frequency. 40 strips comprising 20 CGO and 20 HGO, 305 mm x 30 mm x 0.27 mm from a supplier were tested. The HGO and CGO strips had average grain sizes of 9 mm and 4 mm respectively. Each strip was singly magnetised under sinusoidal peak flux density from 8.0 mT to 1.5 T at a magnetising frequency of 50 Hz. The novel single sheet tester comprises a personal computer in which LabVIEW version 8.5 from National Instruments (NI) was installed, a NI 4461 data acquisition (DAQ) card, an impedance matching transformer, to match the 600  minimum load impedance of the DAQ card with the 5 to 20  low impedance of the magnetising circuit, and a 4.7 Ω shunt resistor. A double vertical yoke made of GOES which is 290 mm long and 32 mm wide is used. A 500-turn secondary winding, about 80 mm in length, was wound around a plastic former, 270 mm x 40 mm, housing the sample, while a 100-turn primary winding, covering the entire length of the plastic former was wound over the secondary winding. A standard Epstein strip to be tested is placed between the yokes. The magnetising voltage was generated by the LabVIEW program through a voltage output from the DAQ card. The voltage drop across the shunt resistor and the secondary voltage were acquired by the card for calculation of magnetic field strength and flux density respectively. A feedback control system implemented in LabVIEW was used to control the flux density and to make the induced secondary voltage waveforms sinusoidal to have repeatable and comparable measurements. The low noise NI4461 card with 24 bit resolution and a sampling rate of 204.8 KHz and 92 KHz bandwidth were chosen to take the measurements to minimize the influence of thermal noise. In order to reduce environmental noise, the yokes, sample and search coil carrier were placed in a noise shielding chamber. HGO was found to have better magnetic properties at both high and low magnetisation regimes. This is because of the higher grain size of HGO and higher grain-grain misorientation of CGO. HGO is better CGO in both low and high magnetic field applications.

Keywords: flux density, electrical steel, LabVIEW, magnetization

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715 Outcome Evaluation of a Blended-Learning Mental Health Training Course in South African Public Health Facilities

Authors: F. Slaven, M. Uys, Y. Erasmus

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The South African National Mental Health Education Programme (SANMHEP) was a National Department of Health (NDoH) initiative to strengthen mental health services in South Africa in collaboration with the Foundation for Professional Development (FPD), SANOFI and the various provincial departments of health. The programme was implemented against the backdrop of a number of challenges in the management of mental health in the country related to staff shortages and infrastructure, the intersection of mental health with the growing burden of non-communicable diseases and various forms of violence, and challenges around substance abuse and its relationship with mental health. The Mental Health Care Act (No. 17 of 2002) prescribes that mental health should be integrated into general health services including primary, secondary and tertiary levels to improve access to services and reduce stigma associated with mental illness. In order for the provisions of the Act to become a reality, and for the journey of mental health patients through the system to improve, sufficient and skilled health care providers are critical. SANMHEP specifically targeted Medical Doctors and Professional Nurses working within the facilities that are listed to conduct 72-hour assessments, as well as District Hospitals. The aim of the programme was to improve the clinical diagnosis and management of mental disorders/conditions and the understanding of and compliance with the Mental Health Care Act and related Regulations and Guidelines in the care, treatment and rehabilitation of mental health care users. The course used a blended-learning approach and trained 1 120 health care providers through 36 workshops between February and November 2019. Of those trained, 689 (61.52%) were Professional Nurses, 337 (30.09%) were Medical Doctors, and 91 (8.13%) indicated their occupation as ‘other’ (of these more than half were psychologists). The pre- and post-evaluation of the face-to-face training sessions indicated a marked improvement in knowledge and confidence level scores (both clinical and legislative) in the care, treatment and rehabilitation of mental health care users by participants in all the training sessions. There was a marked improvement in the knowledge and confidence of participants in performing certain mental health activities (on average the ratings increased by 2.72; or 27%) and in managing certain mental health conditions (on average the ratings increased by 2.55; or 25%). The course also required that participants obtain 70% or higher in their formal assessments as part of the online component. The 337 participants who completed and passed the course scored 90% on average. This illustrates that when participants attempted and completed the course, they did very well. To further assess the effect of the course on the knowledge and behaviour of the trained mental health care practitioners a mixed-method outcome evaluation is currently underway consisting of a survey with participants three months after completion, follow-up interviews with participants, and key informant interviews with department of health officials and course facilitators. This will enable a more detailed assessment of the impact of the training on participants' perceived ability to manage and treat mental health patients.

Keywords: mental health, public health facilities, South Africa, training

Procedia PDF Downloads 102
714 Deficient Multisensory Integration with Concomitant Resting-State Connectivity in Adult Attention Deficit/Hyperactivity Disorder (ADHD)

Authors: Marcel Schulze, Behrem Aslan, Silke Lux, Alexandra Philipsen

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Objective: Patients with Attention Deficit/Hyperactivity Disorder (ADHD) often report that they are being flooded by sensory impressions. Studies investigating sensory processing show hypersensitivity for sensory inputs across the senses in children and adults with ADHD. Especially the auditory modality is affected by deficient acoustical inhibition and modulation of signals. While studying unimodal signal-processing is relevant and well-suited in a controlled laboratory environment, everyday life situations occur multimodal. A complex interplay of the senses is necessary to form a unified percept. In order to achieve this, the unimodal sensory modalities are bound together in a process called multisensory integration (MI). In the current study we investigate MI in an adult ADHD sample using the McGurk-effect – a well-known illusion where incongruent speech like phonemes lead in case of successful integration to a new perceived phoneme via late top-down attentional allocation . In ADHD neuronal dysregulation at rest e.g., aberrant within or between network functional connectivity may also account for difficulties in integrating across the senses. Therefore, the current study includes resting-state functional connectivity to investigate a possible relation of deficient network connectivity and the ability of stimulus integration. Method: Twenty-five ADHD patients (6 females, age: 30.08 (SD:9,3) years) and twenty-four healthy controls (9 females; age: 26.88 (SD: 6.3) years) were recruited. MI was examined using the McGurk effect, where - in case of successful MI - incongruent speech-like phonemes between visual and auditory modality are leading to a perception of a new phoneme. Mann-Whitney-U test was applied to assess statistical differences between groups. Echo-planar imaging-resting-state functional MRI was acquired on a 3.0 Tesla Siemens Magnetom MR scanner. A seed-to-voxel analysis was realized using the CONN toolbox. Results: Susceptibility to McGurk was significantly lowered for ADHD patients (ADHDMdn:5.83%, ControlsMdn:44.2%, U= 160.5, p=0.022, r=-0.34). When ADHD patients integrated phonemes, reaction times were significantly longer (ADHDMdn:1260ms, ControlsMdn:582ms, U=41.0, p<.000, r= -0.56). In functional connectivity medio temporal gyrus (seed) was negatively associated with primary auditory cortex, inferior frontal gyrus, precentral gyrus, and fusiform gyrus. Conclusion: MI seems to be deficient for ADHD patients for stimuli that need top-down attentional allocation. This finding is supported by stronger functional connectivity from unimodal sensory areas to polymodal, MI convergence zones for complex stimuli in ADHD patients.

Keywords: attention-deficit hyperactivity disorder, audiovisual integration, McGurk-effect, resting-state functional connectivity

Procedia PDF Downloads 109
713 Perception of Health Care Providers: A Need to Introduce Screening of Maternal Mental Health at Primary Health Care in Nepal

Authors: Manisha Singh, Padam Simkhada

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Background: Although mental health policy has been adapted in Nepal since 1997, the implementation of the policy framework is yet to happen. The fact that mental health services are largely concentrated in urban areas more specific to treatment only provides a clear picture of the scarcity of mental health services in the country. The shreds of evidence from around the world, along with WHO’s (World Health Organization) Mental Health Gap Action Program (mhGAP) suggest that effective mental health services can be provided from Primary Health Care (PHC) centers through community-based programs without having to place a specialized health worker. However, the country is still facing the same challenges to date with very few psychiatrists and psychologists, but they are largely based in cities. Objectives: The main objectives of this study are; (a) to understand the perception of health workers at PHC on maternal mental health, and (b) to assess the availability of the mental health services at PHC to address maternal mental health. Methods: This study used a qualitative approach where an in-depth interview was conducted with the health workers at the primary level. “Mayadevi” rural municipality in Rupendehi District that comprised of 13 small villages, was chosen as the study site. A total 8 health institutions which covered all 13 sites were included where either the health post in- charge or health worker working in maternal and child health care was interviewed for the study. All the health posts in the study area were included in the study. The interviews were conducted in Nepali; later, they were translated in English, transcribed, and triangulated. NViVO was used for the analysis. Results: The findings show that most of the health workers understood what maternal mental health was and deemed it as a public health issue. They could explain the symptoms and knew what medication to prescribe if need be. However, the majority of them failed to name the screening tools in place for maternal mental health. Moreover, they hadn’t even seen one. None of the health care centers had any provision for screening mental health status. However, one of the centers prescribed medication when the patients displayed symptoms of depression. But they believed there were a significant number of hidden cases in the community due to the stigma around mental health and being a woman with mental health problem makes the situation even difficult. Nonetheless, the health workers understood the importance of having screening tools and acknowledged the need of training and support in order to provide the services from PHC. Conclusion: Community health workers can identify cases with mental health problems and prevent them from deteriorating further. But there is a need for robust training and support to build the capacity of the health workers. The screening tools on mental health needs to be encouraged to be used in the PHC levels. Furthermore, community-based culture-sensitive programs need to be initiated and implemented to mitigate the stigma related issues around mental health.

Keywords: maternal mental health, health care providers, screening, Nepal

Procedia PDF Downloads 105
712 Audio-Visual Co-Data Processing Pipeline

Authors: Rita Chattopadhyay, Vivek Anand Thoutam

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Speech is the most acceptable means of communication where we can quickly exchange our feelings and thoughts. Quite often, people can communicate orally but cannot interact or work with computers or devices. It’s easy and quick to give speech commands than typing commands to computers. In the same way, it’s easy listening to audio played from a device than extract output from computers or devices. Especially with Robotics being an emerging market with applications in warehouses, the hospitality industry, consumer electronics, assistive technology, etc., speech-based human-machine interaction is emerging as a lucrative feature for robot manufacturers. Considering this factor, the objective of this paper is to design the “Audio-Visual Co-Data Processing Pipeline.” This pipeline is an integrated version of Automatic speech recognition, a Natural language model for text understanding, object detection, and text-to-speech modules. There are many Deep Learning models for each type of the modules mentioned above, but OpenVINO Model Zoo models are used because the OpenVINO toolkit covers both computer vision and non-computer vision workloads across Intel hardware and maximizes performance, and accelerates application development. A speech command is given as input that has information about target objects to be detected and start and end times to extract the required interval from the video. Speech is converted to text using the Automatic speech recognition QuartzNet model. The summary is extracted from text using a natural language model Generative Pre-Trained Transformer-3 (GPT-3). Based on the summary, essential frames from the video are extracted, and the You Only Look Once (YOLO) object detection model detects You Only Look Once (YOLO) objects on these extracted frames. Frame numbers that have target objects (specified objects in the speech command) are saved as text. Finally, this text (frame numbers) is converted to speech using text to speech model and will be played from the device. This project is developed for 80 You Only Look Once (YOLO) labels, and the user can extract frames based on only one or two target labels. This pipeline can be extended for more than two target labels easily by making appropriate changes in the object detection module. This project is developed for four different speech command formats by including sample examples in the prompt used by Generative Pre-Trained Transformer-3 (GPT-3) model. Based on user preference, one can come up with a new speech command format by including some examples of the respective format in the prompt used by the Generative Pre-Trained Transformer-3 (GPT-3) model. This pipeline can be used in many projects like human-machine interface, human-robot interaction, and surveillance through speech commands. All object detection projects can be upgraded using this pipeline so that one can give speech commands and output is played from the device.

Keywords: OpenVINO, automatic speech recognition, natural language processing, object detection, text to speech

Procedia PDF Downloads 62
711 Post Disaster Community Support with Family Manga Exhibition as a Tool for Intervention and Outreach: Reflection on the past Five Years from a Narrative Perspective

Authors: Kuniko Muramoto, Tadashi Nakamura, Shiro Dan

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On March 11, 2011 the Great East Japan Disaster caused widespread damage. In the aftermath, we searched for ways to provide long-term support and enhanced resilience to affected areas, arriving at the Family Manga Exhibition: an art collection portraying family life. It became a tool for community outreach and intervention, and we implemented support programs by collaborating with local support agencies. This 10-year project has been touring through four prefectures in Tohoku since the disaster struck, bearing witness to the effects of disaster and recovery alike. At this five-year mark, we use a narrative perspective to present our findings and reflect on post-disaster community support. It is important to note that the exhibition’s art does not directly depict the disaster; it portrays stories of anonymous families instead. They stimulate viewers’ memories and remind them of their own family stories. We analyzed viewers' oral and written responses to the exhibition and discovered that family manga as an art form enhances the viewer’s sense of connection to people close to them. We also discovered that the viewers gained more universal perspective on their own situations by viewing the exhibition. Manga, we found, offered a certain safety by enabling the viewers to control how they would interact with the exhibition's content and themes. In addition, the purpose of the project was for us to become witnesses of the disaster and recovery. Supporters of the project became active listeners, functioning as interactive agents who helped forming stories. Voices of the story tellers and the listeners layered upon each other and, as a result, converged into brand new narratives. The essence of traumatic experience is ‘the sense of overwhelming powerlessness and isolation’. When we redefine trauma as ‘broken relationships’, we can say that ‘enhancing relationships’ and ‘weaving relationships’ are what strengthen our resilience. This project used narrative as a modality to fortify the resilience of people involved by enhancing the social capital of bonding, bridging, and linking. The manga exhibition functioned as a tool to achieve this end, suggesting that similar applications are possible. Programs we held in-between manga exhibitions also served to enhance narratives of resiliency in the regions. However, we will save that story for another time. We hope to continue collecting the precious and polyphonic voices of people to present as stories born out of the Great East Japan Disaster. This effort extends beyond the immediately affected area by helping us prepare our resilience for future disasters.

Keywords: community, manga, narrative, resilience

Procedia PDF Downloads 205
710 Different Response of Pure Arctic Char Salvelinus alpinus and Hybrid (Salvelinus alpinus vs. Salvelinus fontinalis Mitchill) to Various Hyperoxic Regimes

Authors: V. Stejskal, K. Lundova, R. Sebesta, T. Vanina, S. Roje

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Pure strain of Arctic char (AC) Salvelinus alpinus and hybrid (HB) Salvelinus alpinus vs. Salvelinus fontinalis Mitchill belong to fish, which with great potential for culture in recirculating aquaculture systems (RAS). Aquaculture of these fish currently use flow-through systems (FTS), especially in Nordic countries such as Iceland (biggest producer), Norway, Sweden, and Canada. Four different water saturation regimes included normoxia (NOR), permanent hyperoxia (HYP), intermittent hyperoxia (HYP ± ) and regimes where one day of normoxia was followed by one day of hyperoxia (HYP1/1) were tested during 63 days of experiment in both species in two parallel experiments. Fish were reared in two identical RAS system consisted of 24 plastic round tanks (300 L each), drum filter, biological filter with moving beads and submerged biofilter. The temperature was maintained using flow-through cooler during at level of 13.6 ± 0.8 °C. Different water saturation regimes were achieved by mixing of pure oxygen (O₂) with water in three (one for each hyperoxic regime) mixing tower equipped with flowmeter for regulation of gas inflow. The water in groups HYP, HYP1/1 and HYP± was enriched with oxygen up to saturation of 120-130%. In HYP group was this level kept during whole day. In HYP ± group was hyperoxia kept for daylight phase (08:00-20:00) only and during night time was applied normoxia in this group. The oxygen saturation of 80-90% in NOR group was created using intensive aeration in header tank. The fish were fed with commercial feed to slight excess at 2 h intervals within the light phase of the day. Water quality parameters like pH, temperature and level of oxygen was monitoring three times (7 am, 10 am and 6 pm) per day using handy multimeter. Ammonium, nitrite and nitrate were measured in two day interval using spectrophotometry. Initial body weight (BW) was 40.9 ± 8.7 g and 70.6 ± 14.8 in AC and HB group, respectively. Final survival of AC ranged from 96.3 ± 4.6 (HYP) to 100 ± 0.0% in all other groups without significant differences among these groups. Similarly very high survival was reached in trial with HB with levels from 99.2 ± 1.3 (HYP, HYP1/1 and NOR) to 100 ± 0.0% (HYP ± ). HB fish showed best growth performance in NOR group reached final body weight (BW) 180.4 ± 2.3 g. Fish growth under different hyperoxic regimes was significantly reduced and final BW was 164.4 ± 7.6, 162.1 ± 12.2 and 151.7 ± 6.8 g in groups HY1/1, HYP ± and HYP, respectively. AC showed different preference for hyperoxic regimes as there were no significant difference in BW among NOR, HY1/1 and HYP± group with final values of 72.3 ± 11.3, 68.3 ± 8.4 and 77.1 ± 6.1g. Significantly reduced growth (BW 61.8 ± 6.8 g) was observed in HYP group. It is evident from present study that there are differences between pure bred Arctic char and hybrid in relation to hyperoxic regimes. The study was supported by projects 'CENAKVA' (No. CZ.1.05/2.1.00/01.0024), 'CENAKVA II' (No. LO1205 under the NPU I program), NAZV (QJ1510077) and GAJU (No. 060/2016/Z).

Keywords: recirculating aquaculture systems, Salmonidae, hyperoxia, abiotic factors

Procedia PDF Downloads 158
709 Voyage Analysis of a Marine Gas Turbine Engine Installed to Power and Propel an Ocean-Going Cruise Ship

Authors: Mathias U. Bonet, Pericles Pilidis, Georgios Doulgeris

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A gas turbine-powered cruise Liner is scheduled to transport pilgrim passengers from Lagos-Nigeria to the Islamic port city of Jeddah in Saudi Arabia. Since the gas turbine is an air breathing machine, changes in the density and/or mass flow at the compressor inlet due to an encounter with variations in weather conditions induce negative effects on the performance of the power plant during the voyage. In practice, all deviations from the reference atmospheric conditions of 15 oC and 1.103 bar tend to affect the power output and other thermodynamic parameters of the gas turbine cycle. Therefore, this paper seeks to evaluate how a simple cycle marine gas turbine power plant would react under a variety of scenarios that may be encountered during a voyage as the ship sails across the Atlantic Ocean and the Mediterranean Sea before arriving at its designated port of discharge. It is also an assessment that focuses on the effect of varying aerodynamic and hydrodynamic conditions which deteriorate the efficient operation of the propulsion system due to an increase in resistance that results from some projected levels of the ship hull fouling. The investigated passenger ship is designed to run at a service speed of 22 knots and cover a distance of 5787 nautical miles. The performance evaluation consists of three separate voyages that cover a variety of weather conditions in winter, spring and summer seasons. Real-time daily temperatures and the sea states for the selected transit route were obtained and used to simulate the voyage under the aforementioned operating conditions. Changes in engine firing temperature, power output as well as the total fuel consumed per voyage including other performance variables were separately predicted under both calm and adverse weather conditions. The collated data were obtained online from the UK Meteorological Office as well as the UK Hydrographic Office websites, while adopting the Beaufort scale for determining the magnitude of sea waves resulting from rough weather situations. The simulation of the gas turbine performance and voyage analysis was effected through the use of an integrated Cranfield-University-developed computer code known as ‘Turbomatch’ and ‘Poseidon’. It is a project that is aimed at developing a method for predicting the off design behavior of the marine gas turbine when installed and operated as the main prime mover for both propulsion and powering of all other auxiliary services onboard a passenger cruise liner. Furthermore, it is a techno-economic and environmental assessment that seeks to enable the forecast of the marine gas turbine part and full load performance as it relates to the fuel requirement for a complete voyage.

Keywords: cruise ship, gas turbine, hull fouling, performance, propulsion, weather

Procedia PDF Downloads 155
708 Exploring the Challenges of Post-conflict Peacebuilding in the Border Districts of Eastern Zone of Tigray Region

Authors: Gebreselassie Sebhatleab

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According to the Global Peace Index report (GPI, 2023), global peacefulness has deteriorated by more than 0.42%. Old and new conflicts, COVID-19, and political and cultural polarization are the main drivers of conflicts in the world. The 2022 was the deadliest year for armed conflict in the history of the GPI. In Ethiopia, over half a million people died in the Tigray war, which was the largest conflict death event since the 1994 Rwandan genocide. In total, 84 countries recorded an improvement, while 79 countries recorded a deterioration in peacefulness across the globe. The Russia-Ukraine war and its consequences were the main drivers of the deterioration in peacefulness globally. Both Russia and Ukraine are now ranked amongst the ten least peaceful countries, and Ukraine had the largest deterioration of any country in the 2023 GPI. In the same year, the global impact of violence on the economy was 17 percent, which was equivalent to 10.9% of global GDP. Besides, the brutal conflict in Tigray started in November. 2020 claimed more than half a million lives lost and displaced nearly 3 million people, along with widespread human rights violations and sexual violence has left deep damage on the population. The displaced people are still unable to return home because the western, southern and Eastern parts of Tigray are occupied by Eritrean and Amhara forces, despite the Pretoria Agreement. Currently, armed conflicts in Amhara in the Oromya regions are intensified, and human rights violations are being reported in both regions. Meanwhile, protests have been held by war-injured TDF members, IDPs and teachers in the Tigray region. Hence, the general objective of this project is to explore the challenges of peace-building processes in the border woredas of the Eastern Zone of the Tigray Region. Methodologically, the project will employ exploratory qualitative research designs to gather and analyze qualitative data. A purposive sampling technique will be applied to gather pertinent information from the key stakeholders. Open-ended interview questions will be prepared to gather relevant information about the challenges and perceptions of peacebuilding in the study area. Data will be analyzed using qualitative methods such as content analysis, narrative analysis and phenomenological analysis to deeply investigate the challenges of peace-building in the study woredas. Findings of this research project will be employed for program intervention to promote sustainable peace in the study area.

Keywords: peace building, conflcit and violence, political instability, insecurity

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707 Variations in Breast Aesthetic Reconstruction Rates between Asian and Caucasian Patients Post Mastectomy in a UK Tertiary Breast Referral Centre: A Five-Year Institutional Review

Authors: Wisam Ismail, Chole Wright, Elizabeth Baker, Cathy Tait, Mohamed Salhab, Richard Linforth

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Background: Post-mastectomy breast reconstruction is an important treatment option for women with breast cancer with psychosocial, emotional and quality of life benefits. Despite this, Asian patients are one-fifth as likely as Caucasian patients to undergo reconstruction after mastectomy. Aim: This study aimed to assess the difference in breast reconstruction rates between Asian and Caucasian patients treated at Bradford Teaching Hospitals between May 2011 – December 2015.The long-term goal is to equip healthcare professionals to improve breast cancer treatment outcome by increasing breast reconstruction rates in this sub-population. Methods: All patients undergoing mastectomy were identified using a prospectively collected departmental database. Further data was obtained via retrospective electronic case note review. Bradford city population is about 530.000 by the end of 2015, with 67.44% of the city's population was White ethnic groups and 26.83% Asian Ethnic Groups (UK population consensus). The majority of Asian population speaks Urdu, hence an Urdu speaking breast care nurse was appointed to facilitate communications and deliver a better understanding of the reconstruction options and pathways. Statistical analysis was undertaken using the SAS program. Patients were stratified by age, self-reported ethnicity, axillary surgery and reconstruction. Relative odds were calculated using univariate and multivariate logistic regression analyses with adjustment for known confounders. An Urdu speaking breast care nurse was employed throughout this period to facilitate communication and patient decision making. Results: 506 patients underwent Mastectomy over 5 years. 72 (14%) Asian v. 434 (85%) Caucasian. Overall median age is 64 years (SD1.1). Asian median age is 62 (SD0.9), versus Caucasian 65 (SD1.2). Total axillary clearance rate was 30% (42% Asian v.30% Caucasian). Overall reconstruction rate was 126 patients (28.9%).Only 6 of 72 Asian patients (<1%) underwent breast reconstruction versus 121of 434 Caucasian (28%) (p < 0.04), Odds ratio 0.68, (95% confidence interval 0.57-0.79). Conclusions: There is a significant difference in post-mastectomy reconstruction rates between Asian and Caucasian patients. This difference is likely to be multi-factorial. Higher rates of axillary clearance in Asian patients might suggest later disease presentation and/or higher rates of subsequent adjuvant therapy, both of which, can impact on the suitability of breast reconstruction. Strategies aimed at reducing racial disparities in breast reconstruction should include symptom awareness to enable earlier presentation and facilitated communication to ensure informed decision-making.

Keywords: aesthetic, Asian, breast, reconstruction

Procedia PDF Downloads 260
706 Oxidative Stability of Corn Oil Supplemented with Natural Antioxidants from Cypriot Salvia fruticosa Extracts

Authors: Zoi Konsoula

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Vegetable oils, which are rich in polyunsaturated fatty acids, are susceptible to oxidative deterioration. The lipid oxidation of oils results in the production of rancid odors and unpleasant flavors as well as the reduction of their nutritional quality and safety. Traditionally, synthetic antioxidants are employed for their retardation or prevention of oxidative deterioration of oils. However, these compounds are suspected to pose health hazards. Consequently, recently there has been a growing interest in the use of natural antioxidants of plant origin for improving the oxidative stability of vegetable oils. The genus Salvia (sage) is well known for its antioxidant activity. In the Cypriot flora Salvia fruticosa is the most distributed indigenous Salvia species. In the present study, extracts were prepared from S. fruticosa aerial parts using various solvents and their antioxidant activity was evaluated by the 1,1-diphenyl-2-picrylhydrazine (DPPH) radical scavenging and Ferric Reducing Antioxidant Power (FRAP) method. Moreover, the antioxidant efficacy of all extracts was assessed using corn oil as the oxidation substrate, which was subjected to accelerated aging (60 °C, 30 days). The progress of lipid oxidation was monitored by the determination of the peroxide, p-aniside, conjugated dienes and trienes value according to the official AOCS methods. Synthetic antioxidants (butylated hydroxytoluene-BHT and butylated hydroxyanisole-BHA) were employed at their legal limit (200 ppm) as reference. Finally, the total phenolic (TPC) and flavonoid content (TFC) of the prepared extracts was measured by the Folin-Ciocalteu and aluminum-flavonoid complex method, respectively. The results of the present study revealed that although all sage extracts prepared from S. fruticosa exhibited antioxidant activity, the highest antioxidant capacity was recorded in the methanolic extract, followed by the non-toxic, food grade ethanol. Furthermore, a positive correlation between the antioxidant potency and the TPC of extracts was observed in all cases. Interestingly, sage extracts prevented lipid oxidation in corn oil at all concentrations tested, however, the magnitude of stabilization was dose dependent. More specifically, results from the different oxidation parameters were in agreement with each other and indicated that the protection offered by the various extracts depended on their TPC. Among the extracts, the methanolic extract was more potent in inhibiting oxidative deterioration. Finally, both methanolic and ethanolic sage extracts at a concentration of 1000 ppm exerted a stabilizing effect comparable to that of the reference synthetic antioxidants. Based on the results of the present study, sage extracts could be used for minimizing or preventing lipid oxidation in oils and, thus, prolonging their shelf-life. In particular, given that the use of dietary alcohol, such as ethanol, is preferable than methanol in food applications, the ethanolic extract prepared from S. fruticosa could be used as an alternative natural antioxidant.

Keywords: antioxidant activity, corn oil, oxidative deterioration, sage

Procedia PDF Downloads 177
705 Explaining Motivation in Language Learning: A Framework for Evaluation and Research

Authors: Kim Bower

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Evaluating and researching motivation in language learning is a complex and multi-faceted activity. Various models for investigating learner motivation have been proposed in the literature, but no one model supplies a complex and coherent model for investigating a range of motivational characteristics. Here, such a methodological framework, which includes exemplification of sources of evidence and potential methods of investigation, is proposed. The process model for the investigation of motivation within language learning settings proposed is based on a complex dynamic systems perspective that takes account of cognition and affects. It focuses on three overarching aspects of motivation: the learning environment, learner engagement and learner identities. Within these categories subsets are defined: the learning environment incorporates teacher, course and group specific aspects of motivation; learner engagement addresses the principal characteristics of learners' perceived value of activities, their attitudes towards language learning, their perceptions of their learning and engagement in learning tasks; and within learner identities, principal characteristics of self-concept and mastery of the language are explored. Exemplifications of potential sources of evidence in the model reflect the multiple influences within and between learner and environmental factors and the possible changes in both that may emerge over time. The model was initially developed as a framework for investigating different models of Content and Language Integrated Learning (CLIL) in contrasting contexts in secondary schools in England. The study, from which examples are drawn to exemplify the model, aimed to address the following three research questions: (1) in what ways does CLIL impact on learner motivation? (2) what are the main elements of CLIL that enhance motivation? and (3) to what extent might these be transferable to other contexts? This new model has been tried and tested in three locations in England and reported as case studies. Following an initial visit to each institution to discuss the qualitative research, instruments were developed according to the proposed model. A questionnaire was drawn up and completed by one group prior to a 3-day data collection visit to each institution, during which interviews were held with academic leaders, the head of the department, the CLIL teacher(s), and two learner focus groups of six-eight learners. Interviews were recorded and transcribed verbatim. 2-4 naturalistic observations of lessons were undertaken in each setting, as appropriate to the context, to provide colour and thereby a richer picture. Findings were subjected to an interpretive analysis by the themes derived from the process model and are reported elsewhere. The model proved to be an effective and coherent framework for planning the research, instrument design, data collection and interpretive analysis of data in these three contrasting settings, in which different models of language learning were in place. It is hoped that the proposed model, reported here together with exemplification and commentary, will enable teachers and researchers in a wide range of language learning contexts to investigate learner motivation in a systematic and in-depth manner.

Keywords: investigate, language-learning, learner motivation model, dynamic systems perspective

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704 Construction of a Dynamic Migration Model of Extracellular Fluid in Brain for Future Integrated Control of Brain State

Authors: Tomohiko Utsuki, Kyoka Sato

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In emergency medicine, it is recognized that brain resuscitation is very important for the reduction of mortality rate and neurological sequelae. Especially, the control of brain temperature (BT), intracranial pressure (ICP), and cerebral blood flow (CBF) are most required for stabilizing brain’s physiological state in the treatment for such as brain injury, stroke, and encephalopathy. However, the manual control of BT, ICP, and CBF frequently requires the decision and operation of medical staff, relevant to medication and the setting of therapeutic apparatus. Thus, the integration and the automation of the control of those is very effective for not only improving therapeutic effect but also reducing staff burden and medical cost. For realizing such integration and automation, a mathematical model of brain physiological state is necessary as the controlled object in simulations, because the performance test of a prototype of the control system using patients is not ethically allowed. A model of cerebral blood circulation has already been constructed, which is the most basic part of brain physiological state. Also, a migration model of extracellular fluid in brain has been constructed, however the condition that the total volume of intracranial cavity is almost changeless due to the hardness of cranial bone has not been considered in that model. Therefore, in this research, the dynamic migration model of extracellular fluid in brain was constructed on the consideration of the changelessness of intracranial cavity’s total volume. This model is connectable to the cerebral blood circulation model. The constructed model consists of fourteen compartments, twelve of which corresponds to perfused area of bilateral anterior, middle and posterior cerebral arteries, the others corresponds to cerebral ventricles and subarachnoid space. This model enable to calculate the migration of tissue fluid from capillaries to gray matter and white matter, the flow of tissue fluid between compartments, the production and absorption of cerebrospinal fluid at choroid plexus and arachnoid granulation, and the production of metabolic water. Further, the volume, the colloid concentration, and the tissue pressure of/in each compartment are also calculable by solving 40-dimensional non-linear simultaneous differential equations. In this research, the obtained model was analyzed for its validation under the four condition of a normal adult, an adult with higher cerebral capillary pressure, an adult with lower cerebral capillary pressure, and an adult with lower colloid concentration in cerebral capillary. In the result, calculated fluid flow, tissue volume, colloid concentration, and tissue pressure were all converged to suitable value for the set condition within 60 minutes at a maximum. Also, because these results were not conflict with prior knowledge, it is certain that the model can enough represent physiological state of brain under such limited conditions at least. One of next challenges is to integrate this model and the already constructed cerebral blood circulation model. This modification enable to simulate CBF and ICP more precisely due to calculating the effect of blood pressure change to extracellular fluid migration and that of ICP change to CBF.

Keywords: dynamic model, cerebral extracellular migration, brain resuscitation, automatic control

Procedia PDF Downloads 138
703 Exploring the Use of Schoolgrounds for the Integration of Environmental and Sustainability Education in Natural and Social Sciences Pedagogy: A Case Study

Authors: Headman Hebe, Arnold Taringa

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Background of the study: The benefits derived from Environmental and Sustainability Education (ESE) go beyond obtaining knowledge about the environment and the impact of human beings on the environment. Hence, it is sensible to expose learners to various resources that could enable meaningful environment-inclined pedagogy. The schoolgrounds, where they are utilised to promote ESE, benefit holistic learner development. However, empirical evidence, globally, suggests that young children’s contact with nature is declining due to urbanization, safety concerns by parents/guardians, and greater dependency on technology. Modern children spend much time on videogames and social media with very little time in the natural environment. Furthermore, national education departments in numerous countries have made tangible efforts to embed environmental and place-based learning to their school curricula. South Africa is one of those countries whose national school education curriculum advocates for ESE in pedagogy. Nevertheless, there is paucity of research conducted in South Africa on schoolgrounds as potential enablers of ESE and tools to foster a connection between youngsters and the natural environment. Accordingly, this study was essential as it seeks to determine the extent to which environmental learning is accommodated in pedagogy. Significantly, it investigates efforts made to use schoolgrounds for pedagogical purposes to connect children with the natural environment. Therefore, this study was conducted to investigate the accessibility and use of schoolgrounds for environment-inclined pedagogy in Natural and Social Sciences in two schools located in the Mpumalanga Province of South Africa. It tries to answer the question: To what extent are schoolgrounds used to promote environmental and sustainability education in the selected schools?The sub-questions: How do teachers and learners perceive the use of schoolgrounds for environmental and sustainability education activities? How does the organization of schoolgrounds offer opportunities for environmental education activities and accessibility for learners? Research method: This qualitative–interpretive case study used purposive and convenient sampling for participant selection. Forty-six respondents: 40 learners (twenty grade 7 learners per school), 2 school principals and 4 grade 7 participated in this study. Data collection tools were observations, interviews, audio-visual recordings and questionnaires while data analysis was done thematically. Major findings: The findings of the study point to: The lack of teacher training and infrastructure in the schoolgrounds and, no administrative support. Unclear curriculum guidelines on the use of schoolgrounds for ESE. The availability various elements in the schoolgrounds that could aid ESE activities. Learners denied access to certain parts of the schoolgrounds. Lack of time and curriculum demands constrain teachers from using schoolgrounds.

Keywords: affordances, environment and sustainability education, experiential learning, schoolgrounds

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702 Fostering Students’ Cultural Intelligence: A Social Media Experiential Project

Authors: Lorena Blasco-Arcas, Francesca Pucciarelli

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Business contexts have become globalised and digitalised, which requires that managers develop a strong sense of cross-cultural intelligence while working in geographically distant teams by means of digital technologies. How to better equip future managers on these kinds of skills has been put forward as a critical issue in Business Schools. In pursuing these goals, higher education is shifting from a passive lecture approach, to more active and experiential learning approaches that are more suitable to learn skills. For example, through the use of case studies, proposing plausible business problem to be solved by students (or teams of students), these institutions have focused for long in fostering learning by doing. Though, case studies are no longer enough as a tool to promote active teamwork and experiential learning. Moreover, digital advancements applied to educational settings have enabled augmented classrooms, expanding the learning experience beyond the class, which increase students’ engagement and experiential learning. Different authors have highlighted the benefits of digital engagement in order to achieve a deeper and longer-lasting learning and comprehension of core marketing concepts. Clickers, computer-based simulations and business games have become fairly popular between instructors, but still are limited by the fact that are fictional experiences. Further exploration of real digital platforms to implement real, live projects in the classroom seem relevant for marketing and business education. Building on this, this paper describes the development of an experiential learning activity in class, in which students developed a communication campaign in teams using the BuzzFeed platform, and subsequently implementing the campaign by using other social media platforms (e.g. Facebook, Instagram, Twitter…). The article details the procedure of using the project for a marketing module in a Bachelor program with students located in France, Italy and Spain campuses working on multi-campus groups. Further, this paper describes the project outcomes in terms of students’ engagement and analytics (i.e. visits achieved). the project included a survey in order to analyze and identify main aspects related to how the learning experience is influenced by the cultural competence developed through working in geographically distant and culturally diverse teamwork. Finally, some recommendations to use project-based social media tools while working with virtual teamwork in the classroom are provided.

Keywords: cultural competences, experiential learning, social media, teamwork, virtual group work

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701 Ethnic Relations in Social Work Education: A Study of Teachers’ Strategies and Experiences in Sweden

Authors: Helene Jacobson Pettersson, Linda Lill

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Research that combines educational science, social work and migration studies shows that ethnic relations tend to be represented from various angles and with different content. As studied here, it is found in steering documents, literature, and teaching that the construction of ethnic relations related to social work varies in education over time. The study has its actuality in changed preconditions to social work education caused by the demographic development and the on-going globalization in the Swedish society. In this presentation we will explore strategies and experiences of teaching ethnic relations at social work educations in Sweden. The purpose is to investigate the strategies that are used and what content is given to ethnic relations in the social work education. University teachers are interviewed concerning their interpretation of steering documents related to the content and how they transform this in their teaching. Even though there has been a tradition to include aspects as intercultural relations and ethnicity, the norms of the welfare state has continued to be the basis for how to conceptualize people’s way of living and social problems. Additionally, the contemporary migration situation with a large number of refugees coming to Sweden peaking in 2015, dramatically changes the conditions for social work as a practice field. Increasing economic and social tensions in Sweden, becomes a challenge for the universities to support the students to achieve theoretical and critical knowledge and skills needed to work for social change, human rights and equality in the ethnic diverse Swedish society. The study raises questions about how teachers interpret the goals of the social work programs in terms of ethnic relations. How do they transform this into teaching? How are ethnic relations in social work described and problematized in lectures, cases and examinations? The empirical material is based on interviews with teachers involved in the social work education at four Swedish universities. The interviewees were key persons in the sense that they could influence the course content, and they were drawn from different semesters of the program. In depth interviews are made on the themes; personal entrance, description and understanding of ethnic relations in social work, teachers’ conception of students understanding of ethnic relations, and the content, form and strategies for teaching used by the teachers. The analysis is thematic and inspired from narrative analysis. The results show that the subject is relatively invisible in steering documents. The interviewees have experienced changes in the teaching over time, with less focus on intercultural relations and specific cultural competence. Instead ethnic relations are treated more contextually and interacting with categories as gender, class and age. The need of theoretical and critical knowledge of migration and ethnic relations in a broad sense but also for specific professional use is emphasized.

Keywords: ethnic relations, social work education, social change, human rights, equality, ethnic diversity in Sweden

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700 The Relationship between Anthropometric Obesity Indices and Insulin in Children with Metabolic Syndrome

Authors: Mustafa M. Donma, Orkide Donma

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The number of indices developed for the evaluation of obesity both in adults and pediatric population is ever increasing. These indices are also used in cases with metabolic syndrome (MetS), mostly the ultimate form of morbid obesity. Aside from anthropometric measurements, formulas constituted using these parameters also find clinical use. These formulas can be listed as two groups; being weight-dependent and –independent. Some are extremely sophisticated equations and their clinical utility is questionable in routine clinical practice. The aim of this study is to compare presently available obesity indices and find the most practical one. Their associations with MetS components were also investigated to determine their capacities in differential diagnosis of morbid obesity with and without MetS. Children with normal body mass index (N-BMI) and morbid obesity were recruited for this study. Three groups were constituted. Age- and sex- dependent BMI percentiles for morbid obese (MO) children were above 99 according to World Health Organization tables. Of them, those with MetS findings were evaluated as MetS group. Children, whose values were between 85 and 15 were included in N-BMI group. The study protocol was approved by the Ethics Committee of the Institution. Parents filled out informed consent forms to participate in the study. Anthropometric measurements and blood pressure values were recorded. Body mass index, hip index (HI), conicity index (CI), triponderal mass index (TPMI), body adiposity index (BAI), body shape index (ABSI), body roundness index (BRI), abdominal volume index (AVI), waist-to-hip ratio (WHR) and waist circumference+hip circumference/2 ((WC+HC)/2) were the formulas examined within the scope of this study. Routine biochemical tests including fasting blood glucose (FBG), insulin (INS), triglycerides (TRG), high density lipoprotein-cholesterol (HDL-C) were performed. Statistical package program SPSS was used for the evaluation of study data. p<0.05 was accepted as the statistical significance degree. Hip index did not differ among the groups. A statistically significant difference was noted between N-BMI and MetS groups in terms of ABSI. All the other indices were capable of making discrimination between N-BMI-MO, N-BMI- MetS and MO-MetS groups. No correlation was found between FBG and any obesity indices in any groups. The same was true for INS in N-BMI group. Insulin was correlated with BAI, TPMI, CI, BRI, AVI and (WC+HC)/2 in MO group without MetS findings. In MetS group, the only index, which was correlated with INS was (WC+HC)/2. These findings have pointed out that complicated formulas may not be required for the evaluation of the alterations among N-BMI and various obesity groups including MetS. The simple easily computable weight-independent index, (WC+HC)/2, was unique, because it was the only index, which exhibits a valuable association with INS in MetS group. It did not exhibit any correlation with other obesity indices showing associations with INS in MO group. It was concluded that (WC+HC)/2 was pretty valuable practicable index for the discrimination of MO children with and without MetS findings.

Keywords: children, insulin, metabolic syndrome, obesity indices

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699 Challenges Faced by the Parents of Mentally Challenged Children in India

Authors: Chamaraja Parulli

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Family is an important social institution devoted to the growth of a child, and parents are the important agents of socialization. Mentally challenged children are those who are affected by intellectual disability, which is manifested by limitation in intellectual functioning and adoptive behavior. Intellectual disability affects about 3-4 percentage of the general population. Intellectual disability is caused by genetic condition, problems during pregnancy, problems during childbirth, or illness. Mental retardation is the world’s most complex and challenging issue. The stigmatization of disability results in social and economic marginalization. Parents of the mentally challenged children will have a very high level of parenting stress, which is significantly more than the stress perceived by the parents of the children without disability. The prevalence of severe mental disorder called Schizophrenia is among 1.1 percent of the total population in India. On the other hand, 11 to 12 percent is the overall lifetime occurrence rate of mental disorders. While the government has a separate program for mental health, the segment is marred by lack of adequate doctors and infrastructure. Mentally retarded children have certain limitations in mental functioning and skills, which makes them slow learners in speaking, walking, and taking care of their personal needs such as dressing and eating. Accepting a child with mental handicap becomes difficult for parents and to the whole family, as they have to face many problems, including those of management, finance, deprivation of rest, and leisure. Also, the problems faced by the parents can be seen in different areas like – educational, psychological, social, emotional, financial and family related issues. The study brought out various difficulties and problems faced by the parents as well as family members. The findings revealed that the mental retardation is not only a medico-psychological problem but also a socio-cultural problem. The study results, however, indicate that the quality of life of the family having children with mental retardation can be improved to a greater extent by building up a child-friendly ambience at home. The main aim of the present study is to assess the problems faced by the parents of mentally challenged children, with the help of personal interview data collected from the parents of mentally challenged children, residing in Shimoga District of Karnataka State, India. These individuals were selected using stratified random sampling method. Organizing effective intervention programs for parents, family, society, and educational institutions towards reduction of family stress, augmenting the family’s strengths, increasing child’s competence and enhancing the positive attitudes and values of the society will go a long way for the peaceful existence of the mentally challenged children.

Keywords: mentally challenged children, intellectual disability, special children, social infrastructure, differently abled, psychological stress, marginalization

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698 Getting It Right Before Implementation: Using Simulation to Optimize Recommendations and Interventions After Adverse Event Review

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

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

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

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