Search results for: urban open space accessibility

Authors: Fidelis E. Uwumiro, Chimaobi O. Nwevo, Favour O. Osemwota, Victory O. Okpujie, Emeka S. Obi, Omamuyovbi F. Nwoagbe, Ejiroghene Tejere, Joycelyn Adjei-Mensah, Christopher N. Ekeh, Charles T. Ogbodo

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Several risk factors associated with cardiovascular events have been identified as specific to Chronic Kidney Disease (CKD). This study endeavors to validate these CKD-specific risk factors using up-to-date national-level data, thereby highlighting the crucial significance of confirming the validity and generalizability of findings obtained from previous studies conducted on smaller patient populations. The study utilized the nationwide inpatient sample database to identify adult hospitalizations for CKD from 2016 to 2020, employing validated ICD-10-CM/PCS codes. A comprehensive literature review was conducted to identify both traditional and CKD-specific risk factors associated with cardiovascular events. Risk factors and cardiovascular events were defined using a combination of ICD-10-CM/PCS codes and statistical commands. Only risk factors with specific ICD-10 codes and hospitalizations with complete data were included in the study. Cardiovascular events of interest included cardiac arrhythmias, sudden cardiac death, acute heart failure, and acute coronary syndromes. Univariate and multivariate regression models were employed to evaluate the association between chronic kidney disease-specific risk factors and cardiovascular events while adjusting for the impact of traditional CV risk factors such as old age, hypertension, diabetes, hypercholesterolemia, inactivity, and smoking. A total of 690,375 hospitalizations for CKD were included in the analysis. The study population was predominantly male (375,564, 54.4%) and primarily received care at urban teaching hospitals (512,258, 74.2%). The mean age of the study population was 61 years (SD 0.1), and 86.7% (598,555) had a CCI of 3 or more. At least one traditional risk factor for CV events was present in 84.1% of all hospitalizations (580,605), while 65.4% (451,505) included at least one CKD-specific risk factor for CV events. The incidence of CV events in the study was as follows: acute coronary syndromes (41,422; 6%), sudden cardiac death (13,807; 2%), heart failure (404,560; 58.6%), and cardiac arrhythmias (124,267; 18%). 91.7% (113,912) of all cardiac arrhythmias were atrial fibrillations. Significant odds of cardiovascular events on multivariate analyses included: malnutrition (aOR: 1.09; 95% CI: 1.06–1.13; p<0.001), post-dialytic hypotension (aOR: 1.34; 95% CI: 1.26–1.42; p<0.001), thrombophilia (aOR: 1.46; 95% CI: 1.29–1.65; p<0.001), sleep disorder (aOR: 1.17; 95% CI: 1.09–1.25; p<0.001), and post-renal transplant immunosuppressive therapy (aOR: 1.39; 95% CI: 1.26–1.53; p<0.001). The study validated malnutrition, post-dialytic hypotension, thrombophilia, sleep disorders, and post-renal transplant immunosuppressive therapy, highlighting their association with increased risk for cardiovascular events in CKD patients. No significant association was observed between uremic syndrome, hyperhomocysteinemia, hyperuricemia, hypertriglyceridemia, leptin levels, carnitine deficiency, anemia, and the odds of experiencing cardiovascular events.

Keywords: cardiovascular events, cardiovascular risk factors in CKD, chronic kidney disease, nationwide inpatient sample

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Authors: Magdalena Suárez-Ortega, M. Fe. Sánchez-García

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This paper focuses on the analysis of the motivations that lead people to undertake and consolidate their business. It is addressed from the framework of planned behavior theory, which recognizes the importance of the social environment and cultural values, both in the decision to undertake business and in business consolidation. Similarly, it is also based on theories of career development, which emphasize the importance of career management competencies and their connections to other vital aspects of people, including their roles within their families and other personal activities. This connects directly with the impact of entrepreneurship on the career and the professional-personal project of each individual. This study is part of the project titled Career Design and Talent Management (Ministry of Economy and Competitiveness of Spain, State Plan 2013-2016 Excellence Ref. EDU2013-45704-P). The aim of the study is to identify and describe entrepreneurial competencies and motivational profiles in a sample of 248 Spanish entrepreneurs, considering the consolidated profile and the profile in transition (n = 248).In order to obtain the information, the Questionnaire of Motivation and conditioners of the entrepreneurial career (MCEC) has been applied. This consists of 67 items and includes four scales (E1-Conflicts in conciliation, E2-Satisfaction in the career path, E3-Motivations to undertake, E4-Guidance Needs). Cluster analysis (mixed method, combining k-means clustering with a hierarchical method) was carried out, characterizing the groups profiles according to the categorical variables (chi square, p = 0.05), and the quantitative variables (ANOVA). The results have allowed us to characterize three motivational profiles relevant to the motivation, the degree of conciliation between personal and professional life, and the degree of conflict in conciliation, levels of career satisfaction and orientation needs (in the entrepreneurial project and life-career). The first profile is formed by extrinsically motivated entrepreneurs, professionally satisfied and without conflict of vital roles. The second profile acts with intrinsic motivation and also associated with family models, and although it shows satisfaction with their professional career, it finds a high conflict in their family and professional life. The third is composed of entrepreneurs with high extrinsic motivation, professional dissatisfaction and at the same time, feel the conflict in their professional life by the effect of personal roles. Ultimately, the analysis has allowed us to line the kinds of entrepreneurs to different levels of motivation, satisfaction, needs and articulation in professional and personal life, showing characterizations associated with the use of time for leisure, and the care of the family. Associations related to gender, age, activity sector, environment (rural, urban, virtual), and the use of time for domestic tasks are not identified. The model obtained and its implications for the design of training actions and orientation to entrepreneurs is also discussed.

Keywords: motivation, entrepreneurial career, guidance needs, life-work balance, job satisfaction, assessment

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Authors: Lee Tasker, Ali Karrech, Jeffrey Shragge, Matthew Josh

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Monitoring for the deterioration of concrete infrastructure is an important assessment tool for an engineer and difficulties can be experienced with monitoring for deterioration within an infrastructure. If a failure crack, or fluid seepage through such a crack, is observed from the surface often the source location of the deterioration is not known. Geophysical methods are used to assist engineers with assessing the subsurface conditions of materials. Techniques such as Ground Penetrating Radar (GPR) provide information on the location of buried infrastructure such as pipes and conduits, positions of reinforcements within concrete blocks, and regions of voids/cavities behind tunnel lining. This experiment underlines the application of GPR as an infrastructure-monitoring tool to highlight and monitor regions of possible deterioration within a concrete test wall due to an increase in the generation of fractures; in particular, during a time period of applied load to a concrete wall up to and including structural failure. A three-point load was applied to a concrete test wall of dimensions 1700 x 600 x 300 mm³ in increments of 10 kN, until the wall structurally failed at 107.6 kN. At each increment of applied load, the load was kept constant and the wall was scanned using GPR along profile lines across the wall surface. The measured radar amplitude responses of the GPR profiles, at each applied load interval, were reconstructed into depth-slice grids and presented at fixed depth-slice intervals. The corresponding depth-slices were subtracted from each data set to compare the radar amplitude response between datasets and monitor for changes in the radar amplitude response. At lower values of applied load (i.e., 0-60 kN), few changes were observed in the difference of radar amplitude responses between data sets. At higher values of applied load (i.e., 100 kN), closer to structural failure, larger differences in radar amplitude response between data sets were highlighted in the GPR data; up to 300% increase in radar amplitude response at some locations between the 0 kN and 100 kN radar datasets. Distinct regions were observed in the 100 kN difference dataset (i.e., 100 kN-0 kN) close to the location of the final failure crack. The key regions observed were a conical feature located between approximately 3.0-12.0 cm depth from surface and a vertical linear feature located approximately 12.1-21.0 cm depth from surface. These key regions have been interpreted as locations exhibiting an increased change in pore-space due to increased mechanical loading, or locations displaying an increase in volume of micro-cracks, or locations showing the development of a larger macro-crack. The experiment showed that GPR is a useful geophysical monitoring tool to assist engineers with highlighting and monitoring regions of large changes of radar amplitude response that may be associated with locations of significant internal structural change (e.g. crack development). GPR is a non-destructive technique that is fast to deploy in a production setting. GPR can assist with reducing risk and costs in future infrastructure maintenance programs by highlighting and monitoring locations within the structure exhibiting large changes in radar amplitude over calendar-time.

Keywords: 4D GPR, engineering geophysics, ground penetrating radar, infrastructure monitoring

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Authors: Ombir Singh

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In spite of the religious and cultural pre-dominance of the river Ganga in the Indian ethos, fragmentation and degradation of the river continued down the ages. Recognizing the national concern on environmental degradation of the river and its basin, Ministry of Water Resources, River Development & Ganga Rejuvenation (MoWR,RD&GR), Government of India has initiated a number of pilot schemes for the rejuvenation of river Ganga under the ‘Namami Gange’ Programme. Considering the diversity, complexity, and intricacies of forest ecosystems and pivotal multiple functions performed by them and their inter-connectedness with highly dynamic river ecosystems, forestry interventions all along the river Ganga from its origin at Gaumukh, Uttarakhand to its mouth at Ganga Sagar, West Bengal has been planned by the ministry. For that Forest Research Institute (FRI) in collaboration with National Mission for Clean Ganga (NMCG) has prepared a Detailed Project Report (DPR) on Forestry Interventions for Ganga. The Institute has adopted an extensive consultative process at the national and state levels involving various stakeholders relevant in the context of river Ganga and employed a science-based methodology including use of remote sensing and GIS technologies for geo-spatial analysis, modeling and prioritization of sites for proposed forestation and conservation interventions. Four sets of field data formats were designed to obtain the field based information for forestry interventions, mainly plantations and conservation measures along the river course. In response, five stakeholder State Forest Departments had submitted more than 8,000 data sheets to the Institute. In order to analyze a voluminous field data received from five participating states, the Institute also developed a software to collate, analyze and generation of reports on proposed sites in Ganga basin. FRI has developed potential plantation and treatment models for the proposed forestry and other conservation measures in major three types of landscape components visualized in the Ganga riverscape. These are: (i) Natural, (ii) Agriculture, and (iii) Urban Landscapes. Suggested plantation models broadly varied for the Uttarakhand Himalayas and the Ganga Plains in five participating states. Besides extensive plantations in three type of landscapes within the riverscape, various conservation measures such as soil and water conservation, riparian wildlife management, wetland management, bioremediation and bio-filtration and supporting activities such as policy and law intervention, concurrent research, monitoring and evaluation, and mass awareness campaigns have been envisioned in the DPR. The DPR also incorporates the details of the implementation mechanism, budget provisioned for different components of the project besides allocation of budget state-wise to five implementing agencies, national partner organizations and the Nodal Ministry.

Keywords: conservation, Ganga, river, water, forestry interventions

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Authors: Francesco Saverio Angiò

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The Islamic State of Iraq and the Levant / Syria (ISIL/S), Al-Qaeda in the Islamic Maghreb (AQIM) and People Committed to the Propagation of the Prophet's Teachings and Jihad, also known as ‘Boko Haram’ (BH), have fought successfully against Syria and Iraq, Mali, Nigeria’s government, respectively. According to Napoleoni, the ‘shell-state’ concept can explain the economic dimension and the financing model of the ISIL insurgency. However, she argues that AQIM and BH did not properly plan their financial model. Consequently, her idea would not be suitable to these groups. Nevertheless, AQIM and BH’s economic performances and their (short) territorialisation suggest that their financing models respond to a well-defined strategy, which they were able to adapt to new circumstances. Therefore, Napoleoni’s idea of ‘shell-state’ can be applied to the three jihadist armed groups. In the last five years, together with other similar entities, ISIL/S, AQIM and BH have been fighting against governments with insurgent tactics and terrorism acts, conquering and ruling a quasi-state; a physical space they presented as legitimate territorial entity, thanks to a puritan version of the Islamic law. In these territories, they have exploited the traditional local economic networks. In addition, they have contributed to the development of legal and illegal transnational business activities. They have also established a justice system and created an administrative structure to supply services. Napoleoni’s ‘shell-state’ can describe the evolution of ISIL/S, AQIM and BH, which has switched from an insurgency to a proto or a quasi-state entity, enjoying a significant share of power over territories and populations. Napoleoni first developed and applied the ‘Shell-state’ concept to describe the nature of groups such as the Palestine Liberation Organisation (PLO), before using it to explain the expansion of ISIL. However, her original conceptualisation emphasises on the economic dimension of the rise of the insurgency, focusing on the ‘business’ model and the insurgents’ financing management skills, which permits them to turn into an organisation. However, the idea of groups which use, coordinate and grab some territorial economic activities (at the same time, encouraging new criminal ones), can also be applied to administrative, social, infrastructural, legal and military levels of their insurgency, since they contribute to transform the insurgency to the same extent the economic dimension does. In addition, according to Napoleoni’s view, the ‘shell-state’ prism is valid to understand the ISIL/S phenomenon, because the group has carefully planned their financial steps. Napoleoni affirmed that ISIL/S carries out activities in order to promote their conversion from a group relying on external sponsors to an entity that can penetrate and condition local economies. On the contrary, ‘shell-state’ could not be applied to AQIM or BH, which are acting more like smugglers. Nevertheless, despite its failure to control territories, as ISIL has been able to do, AQIM and BH have responded strategically to their economic circumstances and have defined specific dynamics to ensure a flow of stable funds. Therefore, Napoleoni’s theory is applicable.

Keywords: shell-state, jihadist insurgency, proto or quasi-state entity economic planning, strategic financing

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Authors: Laura Irimies, Cosmin Irimies

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The public space all over the world is currently confronted with the aggressive assault of fake news that have lately impacted public agenda setting, collective decisions and social attitudes. Top leaders constantly call out most mainstream news as “fake news” and the public opinion get more confused. "Fake news" are generally defined as false, often sensational, information disseminated under the guise of news reporting and has been declared the word of the year 2017 by Collins Dictionary and it also has been one of the most debated socio-political topics of recent years. Websites which, deliberately or not, publish misleading information are often shared on social media where they essentially increase their reach and influence. According to international reports, the exposure to fake news is an undeniable reality all over the world as the exposure to completely invented information goes up to the 31 percent in the US, and it is even bigger in Eastern Europe countries, such as Hungary (42%) and Romania (38%) or in Mediterranean countries, such as Greece (44%) or Turkey (49%), and lower in Northern and Western Europe countries – Germany (9%), Denmark (9%) or Holland (10%). While the study of fake news (mechanism and effects) is still in its infancy, it has become truly relevant as the phenomenon seems to have a growing impact on democratic systems. Studies conducted by the European Commission show that 83% of respondents out of a total of 26,576 interviewees consider the existence of news that misrepresent reality as a threat for democracy. Studies recently conducted at Arizona State University show that people with higher education can more easily spot fake headlines, but over 30 percent of them can still be trapped by fake information. If we were to refer only to some of the most recent situations in Romania, fake news issues and hidden agenda suspicions related to the massive and extremely violent public demonstrations held on August 10th, 2018 with a strong participation of the Romanian diaspora have been massively reflected by the international media and generated serious debates within the European Commission. Considering the above framework, the study raises four main research questions: 1. Is fake news a problem or just a natural consequence of mainstream media decline and the abundance of sources of information? 2. What are the implications for democracy? 3. Can fake news be controlled without restricting fundamental human rights? 4. How could the public be properly educated to detect fake news? The research uses mostly qualitative but also quantitative methods, content analysis of studies, websites and media content, official reports and interviews. The study will prove the real threat fake news represent and also the need for proper media literacy education and will draw basic guidelines for developing a new and essential skill: that of detecting fake in news in a society overwhelmed by sources of information that constantly roll massive amounts of information increasing the risk of misinformation and leading to inadequate public decisions that could affect democratic stability.

Keywords: agenda setting democracy, fake news, journalism, media literacy

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Authors: Lakshmi N. Reddi, Akanksha Varma Sagi

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Studies on biomimetics are largely developed, deriving inspiration from natural processes in our objective world to develop novel technologies. Recent studies are diverse in nature, making their categorization quite challenging. Based on an exhaustive survey, we developed categorizations based on either the essential elements of nature - air, water, land, fire, and space, or on form/shape, functionality, and process. Such diverse studies as aircraft wings inspired by bird wings, a self-cleaning coating inspired by a lotus petal, wetsuits inspired by beaver fur, and search algorithms inspired by arboreal ant path networks lend themselves to these categorizations. Our categorizations of biomimetic studies allowed us to define a different dimension of biomimetics. This new dimension is not restricted to inspiration from the objective world. It is based on the premise that the biological processes observed in the objective world find their reflections in our human bodies in a variety of ways. For example, the lungs provide the most efficient example for liquid-gas phase exchange, the heart exemplifies a very efficient pumping and circulatory system, and the kidneys epitomize the most effective cleaning system. The main focus of this paper is to bring out the magnificence of the cerebro-spinal system (CSS) insofar as it relates to our current computer architecture. In particular, the paper uses four key measures to analyze the differences between CSS and human- engineered computational systems. These are adaptability, sustainability, energy efficiency, and resilience. We found that the cerebrospinal system reveals some important challenges in the development and evolution of our current computer architectures. In particular, the myriad ways in which the CSS is integrated with other systems/processes (circulatory, respiration, etc) offer useful insights on how the human-engineered computational systems could be made more sustainable, energy-efficient, resilient, and adaptable. In our paper, we highlight the energy consumption differences between CSS and our current computational designs. Apart from the obvious differences in materials used between the two, the systemic nature of how CSS functions provides clues to enhance life-cycles of our current computational systems. The rapid formation and changes in the physiology of dendritic spines and their synaptic plasticity causing memory changes (ex., long-term potentiation and long-term depression) allowed us to formulate differences in the adaptability and resilience of CSS. In addition, the CSS is sustained by integrative functions of various organs, and its robustness comes from its interdependence with the circulatory system. The paper documents and analyzes quantifiable differences between the two in terms of the four measures. Our analyses point out the possibilities in the development of computational systems that are more adaptable, sustainable, energy efficient, and resilient. It concludes with the potential approaches for technological advancement through creation of more interconnected and interdependent systems to replicate the effective operation of cerebro-spinal system.

Keywords: cerebrospinal system, computer architecture, adaptability, sustainability, resilience, energy efficiency

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Authors: Collen Tebogo Masilo, Erik Schmikl

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The demand for the DataMiner product by customers has presented a great challenge for the vendor in Skyline Communications in deploying its limited resources in the form of human resources, financial resources, and office space, to achieve high organisational performance in all its international operations. The rapid growth of the organisation has been unable to efficiently support its existing customers across the globe, and provide services to new customers, due to the limited number of approximately one hundred employees in its employ. The combined descriptive and explanatory case study research methods were selected as research design, making use of a survey questionnaire which was distributed to a sample of 100 respondents. A sample return of 89 respondents was achieved. The sampling method employed was non-probability sampling, using the convenient sampling method. Frequency analysis and correlation between the subscales (the four themes) were used for statistical analysis to interpret the data. The investigation was conducted into mechanisms that can be deployed to balance the high demand for products and the limited production capacity of the company’s Belgian operations across four aspects: demand management strategies, capacity management strategies, communication methods that can be used to align a sales management department, and reward systems in use to improve employee performance. The conclusions derived from the theme ‘demand management strategies’ are that the company is fully aware of the future market demand for its products. However, there seems to be no evidence that there is proper demand forecasting conducted within the organisation. The conclusions derived from the theme 'capacity management strategies' are that employees always have a lot of work to complete during office hours, and, also, employees seem to need help from colleagues with urgent tasks. This indicates that employees often work on unplanned tasks and multiple projects. Conclusions derived from the theme 'communication methods used to align sales management department with operations' are that communication is not good throughout the organisation. This means that information often stays with management, and does not reach non-management employees. This also means that there is a lack of smooth synergy as expected and a lack of good communication between the sales department and the projects office. This has a direct impact on the delivery of projects to customers by the operations department. The conclusions derived from the theme ‘employee reward systems’ are that employees are motivated, and feel that they add value in their current functions. There are currently no measures in place to identify unhappy employees, and there are also no proper reward systems in place which are linked to a performance management system. The research has made a contribution to the body of research by exploring the impact of the four sub-variables and their interaction on the challenges of organisational productivity, in particular where an organisation experiences a capacity problem during its growth stage during tough economic conditions. Recommendations were made which, if implemented by management, could further enhance the organisation’s sustained competitive operations.

Keywords: high demand for products, high organisational performance, limited production capacity, limited resources

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Authors: Jessica Cecchinelli, Amer Ali

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The continuing growth in road traffic and the resultant impact on the level of pollution and safety especially in urban areas have led local and national authorities to reduce traffic speed and flow in major towns and cities. Various boroughs of London have recently reduced the in-city speed limit from 30mph to 20mph mainly to calm traffic, improve safety and reduce noise and vibration. This paper reports the detailed field measurements using noise sensor and analyser and the corresponding theoretical calculations and analysis of the noise levels on a number of roads in the central London Borough of Camden where speed limit was reduced from 30mph to 20mph in all roads except the major routes of the ‘Transport for London (TfL)’. The measurements, which included the key noise levels and scales at residential streets and main roads, were conducted during weekdays and weekends normal and rush hours. The theoretical calculations were done according to the UK procedure ‘Calculation of Road Traffic Noise 1988’ and with conversion to the European L-day, L-evening, L-night, and L-den and other important levels. The current study also includes comparable data and analysis from previously measured noise in the Borough of Camden and other boroughs of central London. Classified traffic flow and speed on the roads concerned were observed and used in the calculation part of the study. Relevant data and description of the weather condition are reported. The paper also reports a field survey in the form of face-to-face interview questionnaires, which was carried out in parallel with the field measurement of noise, in order to ascertain the opinions and views of local residents and workers in the reduced speed zones of 20mph. The main findings are that the reduction in speed had reduced the noise pollution on the studied zones and that the measured and calculated noise levels for each speed zone are closely matched. Among the other findings was that of the field survey of the opinions and views of the local residents and workers in the reduced speed 20mph zones who supported the scheme and felt that it had improved the quality of life in their areas giving a sense of calmness and safety particularly for families with children, the elderly, and encouraged pedestrians and cyclists. The key conclusions are that lowering the speed limit in built-up areas would not just reduce the number of serious accidents but it would also reduce the noise pollution and promote clean modes of transport particularly walking and cycling. The details of the site observations and the corresponding calculations together with critical comparative analysis and relevant conclusions will be reported in the full version of the paper.

Keywords: noise calculation, noise field measurement, road traffic noise, speed limit in london, survey of people satisfaction

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Authors: Philip A. Szlosek, M. Susan Guyer, Mary G. Barnum, Elizabeth M. Mullin

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In the United States, athletic training is a healthcare profession that encompasses the prevention, examination, diagnosis, treatment, and rehabilitation of injuries and medical conditions. Athletic trainers work under the direction of or in collaboration with a physician and are recognized by the American Medical Association as allied healthcare professionals. Internationally, this profession is often known as athletic therapy. As healthcare professionals, athletic trainers must be prepared for autonomous practice immediately after graduation. However, new athletic trainers have been shown to have clinical areas of strength and weakness.To better assess professional readiness and improve the preparedness of new athletic trainers, the factors of athletic training professional readiness must be defined. Limited research exists defining the holistic aspects of professional readiness needed for athletic trainers. Confirming the factors of professional readiness in athletic training could enhance the professional preparation of athletic trainers and result in more highly prepared new professionals. The objective of this study was to further explore and confirm the factors of professional readiness in athletic training. Authors useda qualitative design based in grounded theory. Participants included athletic trainers with greater than 24 months of experience from a variety of work settings from each district of the National Athletic Trainer’s Association. Participants took the demographic questionnaire electronically using Qualtrics Survey Software (Provo UT). After completing the demographic questionnaire, 20 participants were selected to complete one-on-one interviews using GoToMeeting audiovisual web conferencing software. IBM Statistical Package for the Social Sciences (SPSS, v. 21.0) was used to calculate descriptive statistics for participant demographics. The first author transcribed all interviews verbatim and utilized a grounded theory approach during qualitative data analysis. Data were analyzed using a constant comparative analysis and open and axial coding. Trustworthiness was established using reflexivity, member checks, and peer reviews. Analysis revealed four overarching themes, including management, interpersonal relations, clinical decision-making, and confidence. Management was categorized as athletic training services not involving direct patient care and was divided into three subthemes, including administration skills, advocacy, and time management. Interpersonal Relations was categorized as the need and ability of the athletic trainer to properly interact with others. Interpersonal relations was divided into three subthemes, including personality traits, communication, and collaborative practice. Clinical decision-making was categorized as the skills and attributes required by the athletic trainer whenmaking clinical decisions related to patient care. Clinical decision-making was divided into three subthemes including clinical skills, continuing education, and reflective practice. The final theme was confidence. Participants discussed the importance of confidence regarding relationships building, clinical and administrative duties, and clinical decision-making. Overall, participants explained the value of a well-rounded athletic trainer and emphasized that athletic trainers need communication and organizational skills, the ability to collaborate, and must value self-reflection and continuing education in addition to having clinical expertise. Future research should finalize a comprehensive model of professional readiness for athletic training, develop a holistic assessment instrument for athletic training professional readiness, and explore the preparedness of new athletic trainers.

Keywords: autonomous practice, newly certified athletic trainer, preparedness for professional practice, transition to practice skills

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Authors: Ditsapelo M. McFarland

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Background: Despite the availability of the Pap smear services in urban areas in Botswana, most women in such areas do not seem to screen regular for prevention of the cervical cancer disease. Reasons for non-use of the available Pap smear services are not well understood. Beliefs about cancer may influence participation in cancer screening in these women. The purpose of this study was to develop an instrument to measure beliefs about cervical cancer and Pap smear screening among Black women in Botswana, and evaluate the psychometric properties of the instrument. Significance: Instruments that are designed to measure beliefs about cervical cancer and screening among black women in Botswana, as well as in the surrounding region, are presently not available. Valid and reliable instruments are needed for exploration of the women’s beliefs about cervical cancer. Conceptual Framework: The Health Belief Model (HBM) provided a conceptual framework for the study. Methodology: The study was done in four phases: Phase 1: item generation: 15 items were generated from literature review and qualitative data for each of four conceptually defined HBM constructs: Perceived susceptibility, severity, benefits, and barriers (Version 1). Phase 2: content validity: Four experts who were advanced practice nurses of African descent and were familiar with the content and the HBM evaluated the content. Experts rated the items on a 4-point Likert scale ranging from: 1=not relevant, 2=somewhat relevant, 3=relevant and 4=very relevant. Fifty-five items were retained for instrument development: perceived susceptibility - 11, severity - 14, benefits - 15 and barriers - 15, all measuring on a 4-point Likert scale ranging from strongly disagree (1) to strongly agree (4). (Version 2). Phase 3: pilot testing: The instrument was pilot tested on a convenient sample of 30 women in Botswana and revised as needed. Phase 4: reliability: the revised instrument (Version 3) was submitted to a larger sample of women in Botswana (n=300) for reliability testing. The sample included women who were Batswana by birth and decent, were aged 30 years and above and could complete an English questionnaire. Data were collected with the assistance of trained research assistants. Major findings: confirmatory factor analysis of the 55 items found that a number of items did not adequately load in a four-factor solution. Items that exhibited reasonable reliability and had low frequency of missing values (n=36) were retained: perceived barriers (14 items), perceived benefits (8 items), perceived severity (4 items), and perceived susceptibility (10 items). confirmatory factor analysis (principle components) for a four factor solution using varimax rotation demonstrated that these four factors explained 43% of the variation in these 36 items. Conclusion: reliability analysis using Cronbach’s Alpha gave generally satisfactory results with values from 0.53 to 0.89.

Keywords: cervical cancer, factor analysis, psychometric evaluation, varimax rotation

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Authors: Dina Ibrahim Abouelamaiem, Ana Jorge Sobrido, Magdalena Titirici, Paul R. Shearing, Daniel J. L. Brett

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Global warming and scarcity of fossil fuels have had a radical impact on the world economy and ecosystem. The urgent need for alternative energy sources has hence elicited an extensive research for exploiting efficient and sustainable means of energy conversion and storage. Among various electrochemical systems, supercapacitors attracted significant attention in the last decade due to their high power supply, long cycle life compared to batteries and simple mechanism. Recently, the performance of these devices has drastically improved, as tuning of nanomaterials provided efficient charge and storage mechanisms. Carbon materials, in various forms, are believed to pioneer the next generation of supercapacitors due to their attractive properties that include high electronic conductivities, high surface areas and easy processing and functionalization. Cellulose has eco-friendly attributes that are feasible to replace man-made fibers. The carbonization of cellulose yields carbons, including activated carbon and graphite fibers. Activated carbons successively are the most exploited candidates for supercapacitor electrode materials that can be complemented with pseudocapacitive materials to achieve high energy and power densities. In this work, the optimum functionalization conditions of cellulose have been investigated for supercapacitor electrode materials. The precursor was treated with potassium hydroxide (KOH) at different KOH/cellulose ratios prior to the carbonization process in an inert nitrogen atmosphere at 850 °C. The chalky products were washed, dried and characterized with different techniques including transmission electron microscopy (TEM), x-ray tomography and nitrogen adsorption-desorption isotherms. The morphological characteristics and their effect on the electrochemical performances were investigated in two and three-electrode systems. The KOH/cellulose ratios of 0.5:1 and 1:1 exhibited the highest performances with their unique hierarchal porous network structure, high surface areas and low cell resistances. Both samples acquired the best results in three-electrode systems and coin cells with specific gravimetric capacitances as high as 187 F g-1 and 20 F g-1 at a current density of 1 A g-1 and retention rates of 72% and 70%, respectively. This is attributed to the morphology of the samples that constituted of a well-balanced micro-, meso- and macro-porosity network structure. This study reveals that the electrochemical performance doesn’t solely depend on high surface areas but also an optimum pore size distribution, specifically at low current densities. The micro- and meso-pore contribution to the final pore structure was found to dominate at low KOH loadings, reaching ‘equilibrium’ with macropores at the optimum KOH loading, after which macropores dictate the porous network. The wide range of pore sizes is detrimental for the mobility and penetration of electrolyte ions in the porous structures. These findings highlight the influence of various morphological factors on the double-layer capacitances and high performance rates. In addition, they open a platform for the investigation of the optimized conditions for double-layer capacitance that can be coupled with pseudocapacitive materials to yield higher energy densities and capacities.

Keywords: carbon, electrochemical performance, electrodes, KOH/cellulose optimized ratio, morphology, supercapacitor

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Authors: Siti Rahayu, Khairulniza Mohd Puat, Kesavan R., Mohammad Harris A., Jalila, Kunalan G., Fazir Mohamad

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The greatest challenge has been in establishing and maintaining the dedicated nursing team. Continuity is served when nurses are assigned exclusively for managing wound, where they can continue to build expertise and skills. In addition, there is a growing incidence of chronic wounds and recognition of the complexity involved in caring for these patients. We would like to share 4 cases with different techniques of wound management. 1st case, 39 years old gentleman with underlying rheumatoid arthritis with chronic periprosthetic joint infection of right total knee replacement presented with persistent drainage over right knee. Patient was consulted for two stage revision total knee replacement. However, patient only agreed for debridement and retention of implant. After debridement, large medial and lateral wound was treated with Instillation Negative Pressure Wound Therapy Dressings. After several cycle, the wound size reduced, and conventional dressing was applied. 2nd case, 58 years old gentleman with underlying diabetes presented with right foot necrotizing fasciitis with gangrene of 5th toe. He underwent extensive debridement of foot with rays’ amputation of 5th toe. Post debridement patient was started on Instillation Negative Pressure Wound Therapy Dressings. After several cycle of VAC, the wound bed was prepared, and he underwent split skin graft over right foot. 3 rd case, 60 years old gentleman with underlying diabetes mellitus presented with right foot necrotizing soft tissue infection. He underwent rays’ amputation and extensive wound debridement. Upon stabilization of general condition, patient was discharge with regular wound dressing by same nurse and doctor during each visit to clinic follow up. After 6 months of follow up, the wound healed well. 4th case, 38-year-old gentleman had alleged motor vehicle accident and sustained closed fracture right tibial plateau. Open reduction and proximal tibial locking plate were done. At 2 weeks post-surgery, the patient presented with warm, erythematous leg and pus discharge from the surgical site. Empirical antibiotic was started, and wound debridement was done. Intraoperatively, 50cc pus was evacuated, unhealthy muscle and tissue debrided. No loosening of the implant. Patient underwent multiple wound debridement. At 2 weeks post debridement wound healed well, but the proximal aspect was unable to close immediately. This left the proximal part of the implant to be exposed. Patient was then put on VAC dressing for 3 weeks until healthy granulation tissue closes the implant. Meanwhile, antibiotic was change according to culture and sensitivity. At 6 weeks post the first debridement, the wound was completely close, and patient was discharge home well. At 3 months post operatively, patient wound and fracture healed uneventfully and able to ambulate independently. Complex wounds are too serious to be dealt with. Team managing complex wound need continuous support through the provision of educational tools to support their professional development, engagement with local and international expert, as well as highquality products that increase efficiencies in services

Keywords: VAC (Vacuum Assisted Closure), empirical- initial antibiotics, NPWT- negative pressure wound therapy, NF- necrotizing fasciitis, gangrene- blackish discoloration due to poor blood supply

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Authors: Andrés Quiroz, Emilio Hormazabal, Ana Mutis, Fernando Ortega, Manuel Chacón-Fuentes, Leonardo Parra

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Red clover (Trifolium pratense L.) is an important forage species in temperate regions of the world. The main limitation of this species worldwide is a lack of persistence related to the high mortality of plants due to a complex of biotic and abiotic factors, determining a life span of two or three seasons. Because of the importance of red clover in Chile, a red clover breeding program was started at INIA Carillanca Research Center in 1989, with the main objective of improving the survival of plants, forage yield, and persistence. The main selection criteria for selecting new varieties have been based on agronomical parameters and biotic factors. The main biotic factor associated with red clover mortality in Chile is Hylastinus obscurus (Coleoptera: Curculionidae). Both larval and adults feed on the roots, causing weakening and subsequent death of clover plants. Pesticides have not been successful for controlling infestations of this root borer. Therefore, alternative strategies for controlling this pest are a high priority for red clover producers. Currently, the role of semiochemical in the interaction between H. obscurus and red clover plants has been widely studied for our group. Specifically, from the red clover foliage has been identified limonene is eliciting repellency from the root borer. Limonene is generated in the plant from two independent biosynthetic pathways, the mevalonic acid, and deoxyxylulose pathway. Mevalonate pathway enzymes are localized in the cytosol, whereas the deoxyxylulose phosphate pathway enzymes are found in plastids. In summary, limonene can be determinated by enzymatic bioassay using GPP as substrate and by limonene synthase expression. Therefore, the main objective of this work was to study genetic variation of limonene in material provided by INIA´s Red Clover breeding program. Protein extraction was carried out homogenizing 250 mg of leave tissue and suspended in 6 mL of extraction buffer (PEG 1500, PVP-30, 20 mM MgCl2 and antioxidants) and stirred on ice for 20 min. After centrifugation, aliquots of 2.5 mL were desalted on PD-10 columns, resulting in a final volume of 3.5 mL. Protein determination was performed according to Bradford with BSA as a standard. Monoterpene synthase assays were performed with 50 µL of protein extracts transferred into gas-tight 2 mL crimp seal vials after addition of 4 µL MgCl₂ and 41 µL assay buffer. The assay was started by adding 5 µL of a GPP solution. The mixture was incubated for 30 min at 40 °C. Biosynthesized limonene was quantified in a GC equipped with a chiral column and using synthetic R and S-limonene standards. The enzymatic the production of R and S-limonene from different Superqueli-Carillanca genotypes is shown in this work. Preliminary results showed significant differences in limonene content among the genotypes analyzed. These results constitute an important base for selecting genotypes with a high content of this repellent monoterpene towards H. obscurus.

Keywords: head space, limonene enzymatic determination, red clover, Hylastinus obscurus

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Authors: Luis M. Ribeiro, Jorge Raposo, Ricardo Oliveira, David Caballero, Domingos X. Viegas

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Under the scope of European project WUIWATCH a set of experimental tests on house vulnerability was performed in order to assess the resistance of selected house components during the passage of a forest fire. Among the individual elements most affected by the passage of a wildfire the windows are the ones with greater exposure. In this sense, a set of exploratory experimental tests was designed to assess some particular aspects related to the vulnerability of windows and blinds. At the same time, the importance of leaving them closed (as well as the doors inside a house) during a wild fire was explored in order to give some scientific background to guidelines for homeowners. Three sets of tests were performed: 1. Windows and blinds resistance to heat. Three types of protective blinds were tested (aluminium, PVC and wood) on 2 types of windows (single and double pane). The objective was to assess the structures resistance. 2. The influence of air flow on the transport of burning embers inside a house. A room was built to scale, and placed inside a wind tunnel, with one window and one door on opposite sides. The objective was to assess the importance of leaving an inside door opened on the probability of burning embers entering the room. 3. The influence of the dimension of openings on a window or door related to the probability of ignition inside a house. The objective was to assess the influence of different window openings in relation to the amount of burning particles that can enter a house. The main results were: 1. The purely radiative heat source provides 1.5 KW/m2 of heat impact in the structure, while the real fire generates 10 Kw/m2. When protected by the blind, the single pane window reaches 30ºC on both sides, and the double pane window has a differential of 10º from the side facing the heat (30ºC) and the opposite side (40ºC). Unprotected window constantly increases temperature until the end of the test. Window blinds reach considerably higher temperatures. PVC loses its consistency above 150ºC and melts. 2. Leaving the inside door closed results in a positive pressure differential of +1Pa from the outside to the inside, inhibiting the air flow. Opening the door in half or full reverts the pressure differential to -6 and -8 times respectively, favouring the air flow from the outside to the inside. The number of particles entering the house follows the same tendency. 3. As the bottom opening in a window increases from 0,5 cm to 4 cm the number of particles that enter the house per second also increases greatly. From 5 cm until 80cm there is no substantial increase in the number of entering particles. This set of exploratory tests proved to be an added value in supporting guidelines for home owners, regarding self-protection in WUI areas.

Keywords: forest fire, wildland urban interface, house vulnerability, house protective elements

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Authors: Muluwerk Ayele Derebe

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Background: Antenatal care (ANC) is an essential element in the continuum of reproductive health care for preventing preventable pregnancy-related morbidity and mortality. Objective: The aim of this study is to assess the spatial pattern and predictors of ANC visits in Ethiopia. Method: This study was done using Ethiopian Demographic and Health Survey data of 2016 among 7,174 pregnant women aged 15-49 years which was a nationwide community-based cross-sectional survey. Spatial analysis was done using Getis-Ord Gi* statistics to identify hot and cold spot areas of ANC visits. Multilevel glmmTMB packages adjusted for spatial effects were used in R software. Spatial multilevel count regression was conducted to identify predictors of antenatal care visits for pregnant women, and proportional change in variance was done to uncover the effect of individual and community-level factors of ANC visits. Results: The distribution of ANC visits was spatially clustered Moran’s I = 0.271, p<.0.001, ICC = 0.497, p<0.001). The highest spatial outlier areas of ANC visit was found in Amhara (South Wollo, Weast Gojjam, North Shewa), Oromo (west Arsi and East Harariga), Tigray (Central Tigray) and Benishangul-Gumuz (Asosa and Metekel) regions. The data was found with excess zeros (34.6%) and over-dispersed. The expected ANC visit of pregnant women with pregnancy complications was higher at 0.7868 [ARR= 2.1964, 95% CI: 1.8605, 2.5928, p-value <0.0001] compared to pregnant women who had no pregnancy complications. The expected ANC visit of a pregnant woman who lived in a rural area was 1.2254 times higher [ARR=3.4057, 95% CI: 2.1462, 5.4041, p-value <0.0001] as compared to a pregnant woman who lived in an urban. The study found dissimilar clusters with a low number of zero counts for a mean number of ANC visits surrounded by clusters with a higher number of counts of an average number of ANC visits when other variables held constant. Conclusion: This study found that the number of ANC visits in Ethiopia had a spatial pattern associated with socioeconomic, demographic, and geographic risk factors. Spatial clustering of ANC visits exists in all regions of Ethiopia. The predictor age of the mother, religion, mother’s education, husband’s education, mother's occupation, husband's occupation, signs of pregnancy complication, wealth index and marital status had a strong association with the number of ANC visits by each individual. At the community level, place of residence, region, age of the mother, sex of the household head, signs of pregnancy complications and distance to health facility factors had a strong association with the number of ANC visits.

Keywords: Ethiopia, ANC, spatial, multilevel, zero inflated Poisson

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Authors: Joseph M. Rich, Vinay A. Duddalwar, Assad A. Oberai

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Prostate adenocarcinoma is the most common cancer in males, with osseous metastases as the commonest site of metastatic prostate carcinoma (mPC). Treatment monitoring is based on the evaluation and characterization of lesions on multiple imaging studies, including Computed Tomography (CT). Monitoring of the osseous disease burden, including follow-up of lesions and identification and characterization of new lesions, is a laborious task for radiologists. Deep learning algorithms are increasingly used to perform tasks such as identification and segmentation for osseous metastatic disease and provide accurate information regarding metastatic burden. Here, nnUNet was used to produce a model which can segment CT scan images of prostate adenocarcinoma vertebral bone metastatic lesions. nnUNet is an open-source Python package that adds optimizations to deep learning-based UNet architecture but has not been extensively combined with transfer learning techniques due to the absence of a readily available functionality of this method. The IRB-approved study data set includes imaging studies from patients with mPC who were enrolled in clinical trials at the University of Southern California (USC) Health Science Campus and Los Angeles County (LAC)/USC medical center. Manual segmentation of metastatic lesions was completed by an expert radiologist Dr. Vinay Duddalwar (20+ years in radiology and oncologic imaging), to serve as ground truths for the automated segmentation. Despite nnUNet’s success on some medical segmentation tasks, it only produced an average Dice Similarity Coefficient (DSC) of 0.31 on the USC dataset. DSC results fell in a bimodal distribution, with most scores falling either over 0.66 (reasonably accurate) or at 0 (no lesion detected). Applying more aggressive data augmentation techniques dropped the DSC to 0.15, and reducing the number of epochs reduced the DSC to below 0.1. Datasets have been identified for transfer learning, which involve balancing between size and similarity of the dataset. Identified datasets include the Pancreas data from the Medical Segmentation Decathlon, Pelvic Reference Data, and CT volumes with multiple organ segmentations (CT-ORG). Some of the challenges of producing an accurate model from the USC dataset include small dataset size (115 images), 2D data (as nnUNet generally performs better on 3D data), and the limited amount of public data capturing annotated CT images of bone lesions. Optimizations and improvements will be made by applying transfer learning and generative methods, including incorporating generative adversarial networks and diffusion models in order to augment the dataset. Performance with different libraries, including MONAI and custom architectures with Pytorch, will be compared. In the future, molecular correlations will be tracked with radiologic features for the purpose of multimodal composite biomarker identification. Once validated, these models will be incorporated into evaluation workflows to optimize radiologist evaluation. Our work demonstrates the challenges of applying automated image segmentation to small medical datasets and lays a foundation for techniques to improve performance. As machine learning models become increasingly incorporated into the workflow of radiologists, these findings will help improve the speed and accuracy of vertebral metastatic lesions detection.

Keywords: deep learning, image segmentation, medicine, nnUNet, prostate carcinoma, radiomics

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Authors: Swati Mishra

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In recent years, there has been an explosion in Gold NanoParticle (GNP) research, with a rapid increase in publications in diverse fields, including imaging, bioengineering, and molecular biology. GNPs exhibit unique physicochemical properties, including surface plasmon resonance (SPR) and bind amine and thiol groups, allowing surface modification and use in biomedical applications. Nanoparticle functionalization is the subject of intense research at present, with rapid progress being made towards developing biocompatible, multi-functional particles. In the present study, the photochemical method has been done to functionalize various-shaped GNPs like nanostars by the molecules like ninhydrin. Ninhydrin is bactericidal, virucidal, fungicidal, antigen-antibody reactive, and used in fingerprint technology in forensics. The GNPs functionalized with ninhydrin efficiently will bind to the amino acids on the target protein, which is of eminent importance during the pandemic, especially where long-term treatments of COVID- 19 bring many side effects of the drugs. The photochemical method is adopted as it provides low thermal load, selective reactivity, selective activation, and controlled radiation in time, space, and energy. The GNPs exhibit their characteristic spectrum, but a distinctly blue or redshift in the peak will be observed after UV irradiation, ensuring efficient ninhydrin binding. Now, the bound ninhydrin in the GNP carrier, upon chemically reacting with any amino acid, will lead to the formation of Rhumann purple. A common method of GNP production includes citrate reduction of Au [III] derivatives such as aurochloric acid (HAuCl4) in water to Au [0] through a one-step synthesis of size-tunable GNPs. The following reagents are prepared to validate the approach. Reagent A solution 1 is0.0175 grams ninhydrin in 5 ml Millipore water Reagent B 30 µl of HAuCl₄.3H₂O in 3 ml of solution 1 Reagent C 1 µl of gold nanostars in 3 ml of solution 1 Reagent D 6 µl of cetrimonium bromide (CTAB) in 3 ml of solution1 ReagentE 1 µl of gold nanostars in 3 ml of ethanol ReagentF 30 µl of HAuCl₄.₃H₂O in 3 ml of ethanol ReagentG 30 µl of HAuCl₄.₃H₂O in 3 ml of solution 2 ReagentH solution 2 is0.0087 grams ninhydrin in 5 ml Millipore water ReagentI 30 µl of HAuCl₄.₃H₂O in 3 ml of water The reagents were irradiated at 254 nm for 15 minutes, followed by their UV Visible spectroscopy. The wavelength was selected based on the one reported for excitation of a similar molecule Pthalimide. It was observed that the solution B and G deviate around 600 nm, while C peaks distinctively at 567.25 nm and 983.9 nm. Though it is tough to say about the chemical reaction happening, butATR-FTIR of reagents will ensure that ninhydrin is not forming Rhumann purple in the absence of amino acids. Therefore, these experiments, we achieved the functionalization of gold nanostars with ninhydrin corroborated by the deviation in the spectrum obtained in a mixture of GNPs and ninhydrin irradiated with UV light. It prepares them as a carrier molecule totake up amino acids for targeted delivery or germicidal action.

Keywords: gold nanostars, ninhydrin, photochemical method, UV visible specgtroscopy

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Authors: C. Bel, J. Nevado, F. Ciceri, M. Ropacki, T. Hoffmann, P. Lapunzina, C. Buesa

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Background: The Phelan-McDermid syndrome (PMS) is a genetic disorder caused by the deletion of the terminal region of chromosome 22 or mutation of the SHANK3 gene. Shank3 disruption in mice leads to dysfunction of synaptic transmission, which can be restored by epigenetic regulation with both Lysine Specific Demethylase 1 (LSD1) inhibitors. PMS subjects result in a variable degree of intellectual disability, delay or absence of speech, autistic spectrum disorders symptoms, low muscle tone, motor delays and epilepsy. Vafidemstat is an LSD1 inhibitor in Phase II clinical development with a well-established and favorable safety profile, and data supporting the restoration of memory and cognition defects as well as reduction of agitation and aggression in several animal models and clinical studies. Therefore, vafidemstat has the potential to become a first-in-class precision medicine approach to treat PMS patients. Aims: The goal of this research is to perform an observational trial to psychometrically characterize individuals carrying deletions in SHANK3 and build a foundation for subsequent precision psychiatry clinical trials with vafidemstat. Methodology: This study is characterizing the clinical profile of 20 to 40 subjects, > 16-year-old, with genotypically confirmed PMS diagnosis. Subjects will complete a battery of neuropsychological scales, including the Repetitive Behavior Questionnaire (RBQ), Vineland Adaptive Behavior Scales, Escala de Observación para el Diagnostico del Autismo (Autism Diagnostic Observational Scale) (ADOS)-2, the Battelle Developmental Inventory and the Behavior Problems Inventory (BPI). Results: By March 2021, 19 patients have been enrolled. Unsupervised hierarchical clustering of the results obtained so far identifies 3 groups of patients, characterized by different profiles of cognitive and behavioral scores. The first cluster is characterized by low Battelle age, high ADOS and low Vineland, RBQ and BPI scores. Low Vineland, RBQ and BPI scores are also detected in the second cluster, which in contrast has high Battelle age and low ADOS scores. The third cluster is somewhat in the middle for the Battelle, Vineland and ADOS scores while displaying the highest levels of aggression (high BPI) and repeated behaviors (high RBQ). In line with the observation that female patients are generally affected by milder forms of autistic symptoms, no male patients are present in the second cluster. Dividing the results by gender highlights that male patients in the third cluster are characterized by a higher frequency of aggression, whereas female patients from the same cluster display a tendency toward higher repetitive behavior. Finally, statistically significant differences in deletion sizes are detected comparing the three clusters (also after correcting for gender), and deletion size appears to be positively correlated with ADOS and negatively correlated with Vineland A and C scores. No correlation is detected between deletion size and the BPI and RBQ scores. Conclusions: Precision medicine may open a new way to understand and treat Central Nervous System disorders. Epigenetic dysregulation has been proposed to be an important mechanism in the pathogenesis of schizophrenia and autism. Vafidemstat holds exciting therapeutic potential in PMS, and this study will provide data regarding the optimal endpoints for a future clinical study to explore vafidemstat ability to treat shank3-associated psychiatric disorders.

Keywords: autism, epigenetics, LSD1, personalized medicine

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Authors: Salman Imran, Chris Healey

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Traditionally, medical care of children in England and Wales starts from primary care with a referral to secondary care paediatricians who may not investigate further. Many primary care doctors do not undergo a paediatric rotation/exposure in training. As a result, there are many who have not acquired the necessary skills to manage children hence increasing hospital referral. With the current demand on hospitals in the National Health Service managing more problems in the community is needed. One way of handling this is to set up clinics, meetings and huddles in GP surgeries where professionals involved (general practitioner, paediatrician, health visitor, community nurse, dietician, school nurse) come together and share information which can help improve communication and care. The increased awareness and education that paediatricians can impart in this way will help boost confidence for primary care professionals to be able to be more self-sufficient. This has been tried successfully in other regions e.g., St. Mary’s Hospital in London but is crucial for a more rural setting like ours. The primary aim of this project would be to educate specifically GP’s and generally all other health professionals involved. Additional benefits would be providing care nearer home, increasing patient’s confidence in their local surgery, improving communication and reducing unnecessary patient flow to already stretched hospital resources. Methods: This was done as a plan do study act cycle (PDSA). Three clinics were delivered in different practices over six months where feedback from staff and patients was collected. Designated time for teaching/discussion was used which involved some cases from the actual clinics. Both new and follow up patients were included. Two clinics were conducted by a paediatrician and nurse whilst the 3rd involved paediatrician and local doctor. The distance from hospital to clinics varied from two miles to 22 miles approximately. All equipment used was provided by primary care. Results: A total of 30 patients were seen. All patients found the location convenient as it was nearer than the hospital. 70-90% clearly understood the reason for a change in venue. 95% agreed to the importance of their local doctor being involved in their care. 20% needed to be seen in the hospital for further investigations. Patients felt this to be a more personalised, in-depth, friendly and polite experience. Local physicians felt this to be a more relaxed, familiar and local experience for their patients and they managed to get immediate feedback regarding their own clinical management. 90% felt they gained important learning from the discussion time and the paediatrician also learned about their understanding and gaps in knowledge/focus areas. 80% felt this time was valuable for targeted learning. Equipment, information technology, and office space could be improved for the smooth running of any future clinics. Conclusion: The acute paediatric outpatient clinic can be successfully established in primary care facilities. Careful patient selection and adequate facilities are important. We have demonstrated a further step in the reduction of patient flow to hospitals and upskilling primary care health professionals. This service is expected to become more efficient with experience.

Keywords: clinics, education, paediatricians, primary care

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Authors: Guilherme M. Pereira, Kimmo Teinïla, Danilo Custódio, Risto Hillamo, Célia Alves, Pérola de C. Vasconcellos

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South American large cities often present serious air pollution problems and their atmosphere composition is influenced by a variety of emissions sources. The South American Emissions Megacities, and Climate project (SAEMC) has focused on the study of emissions and its influence on climate in the South American largest cities and it also included Lima (Peru) and Medellin (Colombia), sites where few studies of the genre were done. Lima is a coastal city with more than 8 million inhabitants and the second largest city in South America. Medellin is a 2.5 million inhabitants city and second largest city in Colombia; it is situated in a valley. The samples were collected in quartz fiber filters in high volume samplers (Hi-Vol), in 24 hours of sampling. The samples were collected in intensive campaigns in both sites, in July, 2010. Several species were determined in the aerosol samples of Lima and Medellin. Organic and elemental carbon (OC and EC) in thermal-optical analysis; biomass burning tracers (levoglucosan - Lev, mannosan - Man and galactosan - Gal) in high-performance anion exchange ion chromatography with mass spectrometer detection; water soluble ions in ion chromatography. The average particulate matter was similar for both campaigns, the PM10 concentrations were above the recommended by World Health Organization (50 µg m⁻³ – daily limit) in 40% of the samples in Medellin, while in Lima it was above that value in 15% of the samples. The average total ions concentration was higher in Lima (17450 ng m⁻³ in Lima and 3816 ng m⁻³ in Medellin) and the average concentrations of sodium and chloride were higher in this site, these species also had better correlations (Pearson’s coefficient = 0,63); suggesting a higher influence of marine aerosol in the site due its location in the coast. Sulphate concentrations were also much higher at Lima site; which may be explained by a higher influence of marine originated sulphate. However, the OC, EC and monosaccharides average concentrations were higher at Medellin site; this may be due to the lower dispersion of pollutants due to the site’s location and a larger influence of biomass burning sources. The levoglucosan average concentration was 95 ng m⁻³ for Medellin and 16 ng m⁻³ and OC was well correlated with levoglucosan (Pearson’s coefficient = 0,86) in Medellin; suggesting a higher influence of biomass burning over the organic aerosol in this site. The Lev/Man ratio is often related to the type of biomass burned and was close to 18, similar to the observed in previous studies done at biomass burning impacted sites in the Amazon region; backward trajectories also suggested the transport of aerosol from that region. Biomass burning appears to have a larger influence on the air quality in Medellin, in addition the vehicular emissions; while Lima showed a larger influence of marine aerosol during the study period.

Keywords: aerosol transport, atmospheric particulate matter, biomass burning, SAEMC project

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Authors: Sharmila Parmanand

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This paper examines dominant media representations of prostitution in the Philippines and interrogates sex workers’ interactions with the media establishment. This analysis of how sex workers are constituted in media, often as both innocent victims and immoral actors, contributes to an understanding of public discourse on sex work in the Philippines, where decriminalisation has recently been proposed and sex workers are currently classified as potential victims under anti-trafficking laws but also as criminals under the penal code. The first part is an analysis of media coverage of two prominent themes on prostitution: first, raid and rescue operations conducted by law enforcement; and second, prostitution on military bases and tourism hotspots. As a result of pressure from activists and international donors, these two themes often define the policy conversations on sex work in the Philippines. The discourses in written and televised news reports and documentaries from established local and international media sources that address these themes are explored through content analysis. Conclusions are drawn based on specific terms commonly used to refer to sex workers, how sex workers are seen as performing their cultural roles as mothers and wives, how sex work is depicted, associations made between sex work and public health, representations of clients and managers and ‘rescuers’ such as the police, anti-trafficking organisations, and faith-based groups, and which actors are presumed to be issue experts. Images of how prostitution is used as a metaphor for relations between the Philippines and foreign nations are also deconstructed, along with common tropes about developing world female subjects. In general, sex workers are simultaneously portrayed as bad mothers who endanger their family’s morality but also as long-suffering victims who endure exploitation for the sake of their children. They are also depicted as unclean, drug-addicted threats to public health. Their managers and clients are portrayed as cold, abusive, and sometimes violent, and their rescuers as moral and altruistic agents who are essential for sex workers’ rehabilitation and restoration as virtuous citizens. The second part explores sex workers’ own perceptions of their interactions with media, through interviews with members of the Philippine Sex Workers Collective, a loose organisation of sex workers around the Philippines. They reveal that they are often excluded by media practitioners and that they do not feel that they have space for meaningful self-revelation about their work when they do engage with journalists, who seem to have an overt agenda of depicting them as either victims or women of loose morals. In their assessment, media narratives do not necessarily reflect their lived experiences, and in some cases, coverage of rescues and raid operations endangers their privacy and instrumentalises their suffering. Media representations of sex workers may produce subject positions such as ‘victims’ or ‘criminals’ and legitimize specific interventions while foreclosing other ways of thinking. Further, in light of media’s power to reflect and shape public consciousness, it is a valuable academic and political project to examine whether sex workers are able to assert agency in determining how they are represented.

Keywords: discourse analysis, news media, sex work, trafficking

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Authors: Kyong-Ku Yun, Dae-Ae Kim, Kyeo-Re Lee, Kyong Namkung, Seung-Yeon Han

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Micro silica is collected as a by-product of the silicon and ferrosilicon alloy production in electric arc furnace using highly pure quartz, wood chips, coke and the like. It consists of about 85% of silicon which has spherical particles with an average particle size of 150 μm. The bulk density of micro silica varies from 150 to 700kg/m^3 and the fineness ranges from 150,000 to 300,000cm^2/g. An amorphous structure with a high silicon oxide content of micro silica induces an active reaction with calcium hydroxide (Ca(OH)₂) generated by the cement hydrate of a large surface area (about 20 m^² / g), and they are also known to form calcium, silicate, hydrate conjugate (C-S-H). Micro silica tends to act as a filler because of the fine particles and the spherical shape. These particles do not get covered by water and they fit well in the space between the relatively rough cement grains which does not freely fluidize concrete. On the contrary, water demand increases since micro silica particles have a tendency to absorb water because of the large surface area. The overall effect of micro silica depends on the amount of micro silica added with other parameters in the water-(cement + micro silica) ratio, and the availability of superplasticizer. In this research, it was studied on cellular sprayed concrete. This method involves a direct re-production of ready mixed concrete into a high performance at a job site. It could reduce the cost of construction by an adding a cellular and a micro silica into a ready mixed concrete truck in a field. Also, micro silica which is difficult with mixing due to high fineness in the field can be added and dispersed in concrete by increasing the fluidity of ready mixed concrete through the surface activity of cellular. Increased air content is converged to a certain level of air content by spraying and it also produces high-performance concrete by remixing of powders in the process of spraying. As it does not use a field mixing equipment the cost of construction decrease and it can be constructed after installing special spray machine in a commercial pump car. Therefore, use of special equipment is minimized, providing economic feasibility through the utilization of existing equipment. This study was carried out to evaluate a highly reliable method of confirming dispersion through a high performance cellular sprayed concrete. A mixture of 25mm coarse aggregate and river sand was applied to the concrete. In addition, by applying silica fume and foam, silica fume dispersion is confirmed in accordance with foam mixing, and the mean and standard deviation is obtained. Then variation coefficient is calculated to finally evaluate the dispersion. Comparison and analysis of before and after spraying were conducted on the experiment variables of 21L, 35L foam for each 7%, 14% silica fume respectively. Taking foam and silica fume as variables, the experiment proceed. Casting a specimen for each variable, a five-day sample is taken from each specimen for EDS test. In this study, it was examined by an experiment materials, plan and mix design, test methods, and equipment, for the evaluation of dispersion in accordance with micro silica and foam.

Keywords: micro silica, distribution, ready mixed concrete, foam

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Authors: Jeronimo Cox, Tomonari Furukawa

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Magnetometers have become more popular in inertial measurement units (IMU) for their ability to correct estimations using the earth's magnetic field. Accelerometer and gyroscope-based packages fail with dead-reckoning errors accumulated over time. Localization in robotic applications with magnetometer-inclusive IMUs has become popular as a way to track the odometry of slower-speed robots. With high-speed motions, the accumulated error increases over smaller periods of time, making them difficult to track with IMU. Tracking a high-speed motion is especially difficult with limited observability. Visual obstruction of motion leaves motion-tracking cameras unusable. When motions are too dynamic for estimation techniques reliant on the observability of the gravity vector, the use of magnetometers is further justified. As available magnetometer calibration methods are limited with the assumption that background magnetic fields are uniform, estimation in nonuniform magnetic fields is problematic. Hard iron distortion is a distortion of the magnetic field by other objects that produce magnetic fields. This kind of distortion is often observed as the offset from the origin of the center of data points when a magnetometer is rotated. The magnitude of hard iron distortion is dependent on proximity to distortion sources. Soft iron distortion is more related to the scaling of the axes of magnetometer sensors. Hard iron distortion is more of a contributor to the error of attitude estimation with magnetometers. Indoor environments or spaces inside ferrite-based structures, such as building reinforcements or a vehicle, often cause distortions with proximity. As positions correlate to areas of distortion, methods of magnetometer localization include the production of spatial mapping of magnetic field and collection of distortion signatures to better aid location tracking. The goal of this paper is to compare magnetometer methods that don't need pre-productions of magnetic field maps. Mapping the magnetic field in some spaces can be costly and inefficient. Dynamic measurement fusion is used to track the motion of a multi-link system with us. Conventional calibration by data collection of rotation at a static point, real-time estimation of calibration parameters each time step, and using two magnetometers for determining local hard iron distortion are compared to confirm the robustness and accuracy of each technique. With opposite-facing magnetometers, hard iron distortion can be accounted for regardless of position, Rather than assuming that hard iron distortion is constant regardless of positional change. The motion measured is a repeatable planar motion of a two-link system connected by revolute joints. The links are translated on a moving base to impulse rotation of the links. Equipping the joints with absolute encoders and recording the motion with cameras to enable ground truth comparison to each of the magnetometer methods. While the two-magnetometer method accounts for local hard iron distortion, the method fails where the magnetic field direction in space is inconsistent.

Keywords: motion tracking, sensor fusion, magnetometer, state estimation

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Authors: M. Doudi, M. H. Pazandeh, L. Rahimzadeh Torabi

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Bedsores are pressure ulcers that occur on the skin or tissue due to being immobile and lying in bed for extended periods. Bedsores have the potential to progress into open ulcers, increasing the possibility of variety of bacterial infection. Acinetobacter baumannii, a pathogen of considerable clinical importance, exhibited a significant correlation with Bedsores (pressure ulcers) infections, thereby manifesting a wide spectrum of antibiotic resistance. The emergence of drug resistance has led researchers to focus on alternative methods, particularly phage therapy, for tackling bacterial infections. Phage therapy has emerged as a novel therapeutic approach to regulate the activity of these agents. The management of bacterial infections greatly benefits from the clinical utilization of bacteriophages as a valuable antimicrobial intervention. The primary objective of this investigation consisted of isolating and discerning potent bacteriophage capable of targeting multi drug-resistant (MDR) and extensively drug-resistant (XDR) bacteria obtained from pressure ulcers. In present study, analyzed and isolated A. baumannii strains obtained from a cohort of patients suffering from pressure ulcers at Taleghani Hospital in Ahvaz, Iran. An approach that included biochemical and molecular identification techniques was used to determine the taxonomic classification of bacterial isolates at the genus and species levels. The molecular identification process was facilitated by using the 16S rRNA gene in combination with universal primers 27 F, and 1492 R. Bacteriophage was obtained through the isolation process conducted on treatment plant sewage located in Isfahan, Iran. The main goal of this study was to evaluate different characteristics of phage, such as their appearance, range of hosts they can infect, how quickly they can enter a host, their stability at varying temperatures and pH levels, their effectiveness in killing bacteria, the growth pattern of a single phage stage, mapping of enzymatic digestion, and identification of proteomics patterns. The findings demonstrated that an examination was conducted on a sample of 50 specimens, wherein 15 instances of A. baumannii were identified. These microorganisms are the predominant Gram-negative agents known to cause wound infections in individuals suffering from bedsores. The study's findings indicated a high prevalence of antibiotic resistance in the strains isolated from pressure ulcers, excluding the clinical strains that exhibited responsiveness to colistin.According to the findings obtained from assessments of host range and morphological characteristics of bacteriophage VbɸAB-1, it can be concluded that this phage possesses specificity towards A. Baumannii BAH_Glau1001 was classified as a member of the Plasmaviridae family. The bacteriophage mentioned earlier showed the strongest antibacterial effect at a temperature of 18 °C and a pH of 6.5. Through the utilization of sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) analysis on protein fragments, it was established that the bacteriophage VbɸAB-1 exhibited a size range between 50 and 75 kilodaltons (KDa). The numerous research findings on the effectiveness of phages and the safety studies conducted suggest that the phages studied in this research can be considered as a practical solution and recommended approach for controlling and treating stubborn pathogens in burn wounds among hospitalized patients.

Keywords: acinetobacter baumannii, extremely drug- resistant, phage therapy, surgery wound

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Authors: Anishur Rahman, Maria Areias, Diogo Simões, Ana Figeuiredo, Filipa Figueiredo, João Nunes

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The circular economy (CE) has gained increased awareness among academics, businesses, and decision-makers as it stimulates resource circularity in the production and consumption systems. A large epistemological study has explored the principles of CE, but scant attention eagerly focused on analysing how CE is evaluated, consented to, and enforced using economic metabolism data and business intelligent framework. Economic metabolism involves the ongoing exchange of materials and energy within and across socio-economic systems and requires the assessment of vast amounts of data to provide quantitative analysis related to effective resource management. Limited concern, the present work has focused on the regional flows pilot region from Portugal. By addressing this gap, this study aims to promote eco-innovation and sustainability in the regions of Intermunicipal Communities Região de Coimbra, Viseu Dão Lafões and Beiras e Serra da Estrela, using this data to find precise synergies in terms of material flows and give companies a competitive advantage in form of valuable waste destinations, access to new resources and new markets, cost reduction and risk sharing benefits. In our work, emphasis on applying artificial intelligence (AI) and, more specifically, on implementing state-of-the-art deep learning algorithms is placed, contributing to construction a business intelligent approach. With the emergence of new approaches generally highlighted under the sub-heading of AI and machine learning (ML), the methods for statistical analysis of complex and uncertain production systems are facing significant changes. Therefore, various definitions of AI and its differences from traditional statistics are presented, and furthermore, ML is introduced to identify its place in data science and the differences in topics such as big data analytics and in production problems that using AI and ML are identified. A lifecycle-based approach is then taken to analyse the use of different methods in each phase to identify the most useful technologies and unifying attributes of AI in manufacturing. Most of macroeconomic metabolisms models are mainly direct to contexts of large metropolis, neglecting rural territories, so within this project, a dynamic decision support model coupled with artificial intelligence tools and information platforms will be developed, focused on the reality of these transition zones between the rural and urban. Thus, a real decision support tool is under development, which will surpass the scientific developments carried out to date and will allow to overcome imitations related to the availability and reliability of data.

Keywords: circular economy, artificial intelligence, economic metabolisms, machine learning

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Authors: Tatiane Benvenuti, Fernando Hamerski, Alexandre Giacobbo, Andrea M. Bernardes, Marco A. S. Rodrigues

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Population growth in urban areas has caused damages to the environment, a consequence of the uncontrolled dumping of domestic and industrial wastewater. The capacity of some plants to purify domestic and agricultural wastewater has been demonstrated by several studies. Since natural wetlands have the ability to transform, retain and remove nutrients, constructed wetlands have been used for wastewater treatment. They are widely recognized as an economical, efficient and environmentally acceptable means of treating many different types of wastewater. T. domingensis Pers. species have shown a good performance and low deployment cost to extract, detoxify and sequester pollutants. Constructed Floating Wetlands (CFWs) consist of emergent vegetation established upon a buoyant structure, floating on surface waters. The upper parts of the vegetation grow and remain primarily above the water level, while the roots extend down in the water column, developing an extensive under water-level root system. Thus, the vegetation grows hydroponically, performing direct nutrient uptake from the water column. Biofilm is attached on the roots and rhizomes, and as physical and biochemical processes take place, the system functions as a natural filter. The aim of this study is to diagnose the application of macrophytes in artificial floating in the treatment of domestic sewage in south Brazil. The T. domingensis Pers. plants were placed in a flotation system (polymer structure), in full scale, in a sewage treatment plant. The sewage feed rate was 67.4 m³.d⁻¹ ± 8.0, and the hydraulic retention time was 11.5 d ± 1.3. This CFW treat the sewage generated by 600 inhabitants, which corresponds to 12% of the population served by this municipal treatment plant. During 12 months, samples were collected every two weeks, in order to evaluate parameters as chemical oxygen demand (COD), biochemical oxygen demand in 5 days (BOD5), total Kjeldahl nitrogen (TKN), total phosphorus, total solids, and metals. The average removal of organic matter was around 55% for both COD and BOD5. For nutrients, TKN was reduced in 45.9% what was similar to the total phosphorus removal, while for total solids the reduction was 33%. For metals, aluminum, copper, and cadmium, besides in low concentrations, presented the highest percentage reduction, 82.7, 74.4 and 68.8% respectively. Chromium, iron, and manganese removal achieved values around 40-55%. The use of T. domingensis Pers. in artificial floating for sewage treatment is an effective and innovative alternative in Brazilian sewage treatment systems. The evaluation of additional parameters in the treatment system may give useful information in order to improve the removal efficiency and increase the quality of the water bodies.

Keywords: constructed wetland, floating system, sewage treatment, Typha domingensis Pers.

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Authors: Bhupendra G. Prajapati, Alpesh R. Patel

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The aim of this research work is to develop sustained release multi-particulates dosage form of Dexketoprofen trometamol, which is the pharmacologically active isomer of ketoprofen. The objective is to utilization of active enantiomer with minimal dose and administration frequency, extended release multi-particulates dosage form development for better patience compliance was explored. Drug loaded and sustained release coated pellets were prepared by fluidized bed coating principle by wurster coater. Microcrystalline cellulose as core pellets, povidone as binder and talc as anti-tacking agents were selected during drug loading while Kollicoat SR 30D as sustained release polymer, triethyl citrate as plasticizer and micronized talc as an anti-adherent were used in sustained release coating. Binder optimization trial in drug loading showed that there was increase in process efficiency with increase in the binder concentration. 5 and 7.5%w/w concentration of Povidone K30 with respect to drug amount gave more than 90% process efficiency while higher amount of rejects (agglomerates) were observed for drug layering trial batch taken with 7.5% binder. So for drug loading, optimum Povidone concentration was selected as 5% of drug substance quantity since this trial had good process feasibility and good adhesion of the drug onto the MCC pellets. 2% w/w concentration of talc with respect to total drug layering solid mass shows better anti-tacking property to remove unnecessary static charge as well as agglomeration generation during spraying process. Optimized drug loaded pellets were coated for sustained release coating from 16 to 28% w/w coating to get desired drug release profile and results suggested that 22% w/w coating weight gain is necessary to get the required drug release profile. Three critical process parameters of Wurster coating for sustained release were further statistically optimized for desired quality target product profile attributes like agglomerates formation, process efficiency, and drug release profile using central composite design (CCD) by Minitab software. Results show that derived design space consisting 1.0 to 1.2 bar atomization air pressure, 7.8 to 10.0 gm/min spray rate and 29-34°C product bed temperature gave pre-defined drug product quality attributes. Scanning Image microscopy study results were also dictate that optimized batch pellets had very narrow particle size distribution and smooth surface which were ideal properties for reproducible drug release profile. The study also focused on optimized dexketoprofen trometamol pellets formulation retain its quality attributes while administering with common vehicle, a liquid (water) or semisolid food (apple sauce). Conclusion: Sustained release multi-particulates were successfully developed for dexketoprofen trometamol which may be useful to improve acceptability and palatability of a dosage form for better patient compliance.

Keywords: dexketoprofen trometamol, pellets, fluid bed technology, central composite design

Procedia PDF Downloads 117

Authors: Fida Isam Abdulhafiz

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Traditional vernacular architecture in the United Arab Emirates constituted namely of adobe houses with a limited number of openings in their facades. The thick mud and rubble walls and wooden window screens protected its inhabitants from the harsh desert climate and provided them with privacy and fulfilled their comfort zone needs to an extent. However, with the rise of the immediate post petroleum era reinforced concrete villas with glass and steel technology has replaced traditional vernacular dwellings. And more load was put on the mechanical cooling systems to ensure the satisfaction of today’s more demanding doweling inhabitants. However, In the early 21at century professionals started to pay more attention to the carbon footprint caused by the built constructions. In addition, many studies and innovative approaches are now dedicated to lower the impact of the existing operating buildings on their surrounding environments. The UAE government agencies started to regulate that aim to revive sustainable and environmental design through Local and international building codes and urban design policies such as Estidama and LEED. The focus in this paper is on the reduction of the emissions resulting from the use of energy sources in the cooling and heating systems, and that would be through using innovative screen designs and façade solutions to provide a green footprint and aesthetic architectural icons. Screens are one of the popular innovative techniques that can be added in the design process or used in existing building as a renovation techniques to develop a passive green buildings. Preparing future architects to understand the importance of environmental design was attempted through physical modelling of window screens as an educational means to combine theory with a hands on teaching approach. Designing screens proved to be a popular technique that helped them understand the importance of sustainable design and passive cooling. After creating models of prototype screens, several tests were conducted to calculate the amount of Sun, light and wind that goes through the screens affecting the heat load and light entering the building. Theory further explored concepts of green buildings and material that produce low carbon emissions. This paper highlights the importance of hands on experience for student architects and how physical modelling helped rise eco awareness in Design studio. The paper will study different types of façade screens and shading devices developed by Architecture students and explains the production of diverse patterns for traditional screens by student architects based on sustainable design concept that works properly with the climate requirements in the Middle East region.

Keywords: building’s screens modeling, façade design, sustainable architecture, sustainable dwellings, sustainable education

Procedia PDF Downloads 274

Authors: Hitesh Kshayap, Shantanu Arya, Ajay Basod, Sachin Sakhuja

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This study was undertaken to measure the overall noise levels in different locations/zones and to estimate the prevalence of Noise induced hearing loss in Hawkers & Shopkeepers in Mumbai, India. The Hearing Test developed by American Academy Of Otolaryngology, translated from English to Hindi, and validated is used as a screening tool for hearing sensitivity was employed. The tool is having 14 items. Each item is scored on a scale 0, 1, 2 and 3. The score 6 and above indicated some difficulty or definite difficulty in hearing in daily activities and low score indicated lesser difficulty or normal hearing. The subjects who scored 6 or above or having tinnitus were made to undergo hearing evaluation by Pure tone audiometer. Further, the environmental noise levels were measured from Morning to Evening at road side at different Location/Hawking zones in Mumbai city using SLM9 Agronic 8928B & K type Digital Sound Level Meter) in dB (A). The maximum noise level of 100.0 dB (A) was recorded during evening hours from Chattrapati Shivaji Terminal to Colaba with overall noise level of 79.0 dB (A). However, the minimum noise level in this area was 72.6 dB (A) at any given point of time. Further, 54.6 dB (A) was recorded as minimum noise level during 8-9 am at Sion Circle. Further, commencement of flyovers with 2-tier traffic, sky walks, increasing number of vehicular traffic at road, high rise buildings and other commercial & urbanization activities in the Mumbai city most probably have resulted in increasing the overall environmental noise levels. Trees which acted as noise absorbers have been cut owing to rapid construction. The study involved 100 participants in the age range of 18 to 40 years of age, with the mean age of 29 years (S.D. =6.49). 46 participants having tinnitus or have obtained the score of 6 were made to undergo Pure Tone Audiometry and it was found that the prevalence rate of hearing loss in hawkers & shopkeepers is 19% (10% Hawkers and 9 % Shopkeepers). The results found indicates that 29 (42.6%) out of 64 Hawkers and 17 (47.2%) out of 36 Shopkeepers who underwent PTA had no significant difference in percentage of Noise Induced Hearing loss. The study results also reveal that participants who exhibited tinnitus 19 (41.30%) out of 46 were having mild to moderate sensorineural hearing loss between 3000Hz to 6000Hz. The Pure tone Audiogram pattern revealed Hearing loss at 4000 Hz and 6000 Hz while hearing at adjacent frequencies were nearly normal. 7 hawkers and 8 shopkeepers had mild notch while 3 hawkers and 1 shopkeeper had a moderate degree of notch. It is thus inferred that tinnitus is a strong indicator for presence of hearing loss and 4/6 KHz notch is a strong marker for road/traffic/ environmental noise as an occupational hazard for hawkers and shopkeepers. Mass awareness about these occupational hazards, regular hearing check up, early intervention along with sustainable development juxtaposed with social and urban forestry can help in this regard.

Keywords: NIHL, noise, sound level meter, tinnitus

Procedia PDF Downloads 172