Search results for: common pool resources
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 10586

Search results for: common pool resources

956 Understanding Face-to-Face Household Gardens’ Profitability and Local Economic Opportunity Pathways

Authors: Annika Freudenberger, Sin Sokhong

Abstract:

In just a few years, the Face-to-Face Victory Gardens Project (F2F) in Cambodia has developed a high-impact project that has provided immediate and tangible benefits to local families. This has been accomplished with a relatively hands-off approach that relies on households’ own motivation and personal investments of time and resources -which is both unique and impressive in the landscape of NGO and government initiatives in the area. Households have been growing food both for their own consumption and to sell or exchange. Not all targeted beneficiaries are equally motivated and maximizing their involvement, but there is a clear subset of households -particularly those who serve as facilitators- whose circumstances have been transformed as a result of F2F. A number of household factors and contextual economic factors affect families’ income generation opportunities. All the households we spoke with became involved with F2F with the goal of selling some proportion of their produce (i.e., not exclusively for their own consumption). For some, this income is marginal and supplemental to their core household income; for others, it is substantial and transformative. Some engage directly with customers/buyers in their immediate community, while others sell in larger nearby markets, and others link up with intermediary vendors. All struggle, to a certain extent, to compete in a local economy flooded with cheap produce imported from large-scale growers in neighboring provinces, Thailand, and Vietnam, although households who grow and sell herbs and greens popular in Khmer cuisine have found a stronger local market. Some are content with the scale of their garden, the income they make, and the current level of effort required to maintain it; others would like to expand but are faced with land constraints and water management challenges. Households making a substantial income from selling their products have achieved success in different ways, making it difficult to pinpoint a clear “model” for replication. Within our small sample size of interviewees, it seems as though the families with a clear passion for their gardens and high motivation to work hard to bring their products to market have succeeded in doing so. Khmer greens and herbs have been the most successful; they are not high-value crops, but they are fairly easy to grow, and there is a constant demand. These crops are also not imported as much, so prices are more stable than those of crops such as long beans. Although we talked to a limited number of individuals, it also appears as though successful families either restricted their crops to those that would grow well in drought or flood conditions (depending on which they are affected by most); or benefit already from water management infrastructure such as water tanks which helps them diversify their crops and helps them build their resilience.

Keywords: food security, Victory Gardens, nutrition, Cambodia

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955 Clinical Validation of C-PDR Methodology for Accurate Non-Invasive Detection of Helicobacter pylori Infection

Authors: Suman Som, Abhijit Maity, Sunil B. Daschakraborty, Sujit Chaudhuri, Manik Pradhan

Abstract:

Background: Helicobacter pylori is a common and important human pathogen and the primary cause of peptic ulcer disease and gastric cancer. Currently H. pylori infection is detected by both invasive and non-invasive way but the diagnostic accuracy is not up to the mark. Aim: To set up an optimal diagnostic cut-off value of 13C-Urea Breath Test to detect H. pylori infection and evaluate a novel c-PDR methodology to overcome of inconclusive grey zone. Materials and Methods: All 83 subjects first underwent upper-gastrointestinal endoscopy followed by rapid urease test and histopathology and depending on these results; we classified 49 subjects as H. pylori positive and 34 negative. After an overnight, fast patients are taken 4 gm of citric acid in 200 ml water solution and 10 minute after ingestion of the test meal, a baseline exhaled breath sample was collected. Thereafter an oral dose of 75 mg 13C-Urea dissolved in 50 ml water was given and breath samples were collected upto 90 minute for 15 minute intervals and analysed by laser based high precisional cavity enhanced spectroscopy. Results: We studied the excretion kinetics of 13C isotope enrichment (expressed as δDOB13C ‰) of exhaled breath samples and found maximum enrichment around 30 minute of H. pylori positive patients, it is due to the acid mediated stimulated urease enzyme activity and maximum acidification happened within 30 minute but no such significant isotopic enrichment observed for H. pylori negative individuals. Using Receiver Operating Characteristic (ROC) curve an optimal diagnostic cut-off value, δDOB13C ‰ = 3.14 was determined at 30 minute exhibiting 89.16% accuracy. Now to overcome grey zone problem we explore percentage dose of 13C recovered per hour, i.e. 13C-PDR (%/hr) and cumulative percentage dose of 13C recovered, i.e. c-PDR (%) in exhaled breath samples for the present 13C-UBT. We further explored the diagnostic accuracy of 13C-UBT by constructing ROC curve using c-PDR (%) values and an optimal cut-off value was estimated to be c-PDR = 1.47 (%) at 60 minute, exhibiting 100 % diagnostic sensitivity , 100 % specificity and 100 % accuracy of 13C-UBT for detection of H. pylori infection. We also elucidate the gastric emptying process of present 13C-UBT for H. pylori positive patients. The maximal emptying rate found at 36 minute and half empting time of present 13C-UBT was found at 45 minute. Conclusions: The present study exhibiting the importance of c-PDR methodology to overcome of grey zone problem in 13C-UBT for accurate determination of infection without any risk of diagnostic errors and making it sufficiently robust and novel method for an accurate and fast non-invasive diagnosis of H. pylori infection for large scale screening purposes.

Keywords: 13C-Urea breath test, c-PDR methodology, grey zone, Helicobacter pylori

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954 Petrology of the Post-Collisional Dolerites, Basalts from the Javakheti Highland, South Georgia

Authors: Bezhan Tutberidze

Abstract:

The Neogene-Quaternary volcanic rocks of the Javakheti Highland are products of post-collisional continental magmatism and are related to divergent and convergent margins of Eurasian-Afroarabian lithospheric plates. The studied area constitutes an integral part of the volcanic province of Central South Georgia. Three cycles of volcanic activity are identified here: 1. Late Miocene-Early Pliocene, 2. Late Pliocene-Early /Middle/ Pleistocene and 3. Late Pleistocene. An intense basic dolerite magmatic activity occurred within the time span of the Late Pliocene and lasted until at least Late /Middle/ Pleistocene. The age of the volcanogenic and volcanogenic-sedimentary formation was dated by geomorphological, paleomagnetic, paleontological and geochronological methods /1.7-1.9 Ma/. The volcanic area of the Javakheti Highland contains multiple dolerite Plateaus: Akhalkalaki, Gomarethi, Dmanisi, and Tsalka. Petrographic observations of these doleritic rocks reveal fairly constant mineralogical composition: olivine / Fo₈₇.₆₋₈₂.₇ /, plagioclase / Ab₂₂.₈ An₇₅.₉ Or₁.₃; Ab₄₅.₀₋₃₂.₃ An₅₂.₉₋₆₂.₃ Or₂.₁₋₅.₄/. The pyroxene is an augite and may exhibit a visible zoning: / Wo 39.7-43.1 En 43.5-45.2 Fs 16.8-11.7/. Opaque minerals /magnetite, titanomagnetite/ is abundant as inclusions within olivine and pyroxene crystals. The texture of dolerites exhibits intergranular, holocrystalline to ophitic to sub ophitic granular. Dolerites are most common vesicular rocks. Vesicles range in shape from spherical to elongated and in size from 0.5 mm to than 1.5-2 cm and makeup about 20-50 % of the volume. The dolerites have been subjected to considerable alteration. The secondary minerals in the geothermal field are: zeolite, calcite, chlorite, aragonite, clay-like mineral /dominated by smectites/ and iddingsite –like mineral; rare quartz and pumpellyite are present. These vesicles are filled by secondary minerals. In the chemistry, dolerites are the calc-alkalic transition to sub-alkaline with a predominance of Na₂O over K₂O. Chemical analyses indicate that dolerites of all plateaus of the Javakheti Highland have similar geochemical compositions, signifying that they were formed from the same magmatic source by crystallization of olivine basalis magma which less differentiated / ⁸⁷Sr \ ⁸⁶Sr 0.703920-0704195/. There is one argument, which is less convincing, according to which the dolerites/basalts of the Javakheti Highland are considered to be an activity of a mantle plume. Unfortunately, there does not exist reliable evidence to prove this. The petrochemical peculiarities and eruption nature of the dolerites of the Javakheti Plateau point against their plume origin. Nevertheless, it is not excluded that they influence the formation of dolerite producing primary basaltic magma.

Keywords: calc-alkalic, dolerite, Georgia, Javakheti Highland

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953 Damage-Based Seismic Design and Evaluation of Reinforced Concrete Bridges

Authors: Ping-Hsiung Wang, Kuo-Chun Chang

Abstract:

There has been a common trend worldwide in the seismic design and evaluation of bridges towards the performance-based method where the lateral displacement or the displacement ductility of bridge column is regarded as an important indicator for performance assessment. However, the seismic response of a bridge to an earthquake is a combined result of cyclic displacements and accumulated energy dissipation, causing damage to the bridge, and hence the lateral displacement (ductility) alone is insufficient to tell its actual seismic performance. This study aims to propose a damage-based seismic design and evaluation method for reinforced concrete bridges on the basis of the newly developed capacity-based inelastic displacement spectra. The capacity-based inelastic displacement spectra that comprise an inelastic displacement ratio spectrum and a corresponding damage state spectrum was constructed by using a series of nonlinear time history analyses and a versatile, smooth hysteresis model. The smooth model could take into account the effects of various design parameters of RC bridge columns and correlates the column’s strength deterioration with the Park and Ang’s damage index. It was proved that the damage index not only can be used to accurately predict the onset of strength deterioration, but also can be a good indicator for assessing the actual visible damage condition of column regardless of its loading history (i.e., similar damage index corresponds to similar actual damage condition for the same designed columns subjected to very different cyclic loading protocols as well as earthquake loading), providing a better insight into the seismic performance of bridges. Besides, the computed spectra show that the inelastic displacement ratio for far-field ground motions approximately conforms to the equal displacement rule when structural period is larger than around 0.8 s, but that for near-fault ground motions departs from the rule in the whole considered spectral regions. Furthermore, the near-fault ground motions would lead to significantly greater inelastic displacement ratio and damage index than far-field ground motions and most of the practical design scenarios cannot survive the considered near-fault ground motion when the strength reduction factor of bridge is not less than 5.0. Finally, the spectrum formula is presented as a function of structural period, strength reduction factor, and various column design parameters for far-field and near-fault ground motions by means of the regression analysis of the computed spectra. And based on the developed spectrum formula, a design example of a bridge is presented to illustrate the proposed damage-based seismic design and evaluation method where the damage state of the bridge is used as the performance objective.

Keywords: damage index, far-field, near-fault, reinforced concrete bridge, seismic design and evaluation

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952 Increased Availability and Accessibility of Family Planning Services: An Approach Leading to Improved Contraceptive Uptake and Reproductive Behavior of Women Living in Pakistan

Authors: Lutaf Ali, Haris Ahmed, Hina Najmi

Abstract:

Background: Access, better counseling and quality in the provision of family planning services remain big challenges. Sukh Initiative (a project of three different foundations) is a multi-pronged approach, working in one million underserved population residing peri urban slums in Karachi and providing door to door services by lady health workers (LHWs) and community health workers (CHWs) linked with quality family planning and reproductive (FP/RH) services both at public and private health care facilities. Objective: To assess the improvement in family planning and reproductive health behavior among MWRAs by improving access in peri-urban-underserved population of Karachi. Methodology: Using cross sectional study design 3866 married women with reproductive age (MWRAs) were interviewed in peri urban region of Karachi during November 2016 to January 2017. All face to face structured interviews were conducted with women aged 15-49 currently living with their husbands. Based on the project intervention question on reproductive health were developed and questions on contraceptive use were adopted from PDHS- Pakistan 2013. Descriptive and inferential analysis was performed on SPSS version 22. Results: 65% of population sample are literate, 51% women were in young age group- 15–29. On the poverty index, 6% of the population sample living at national poverty line 1.25$ and 52% at 2.50$. During the project years 79% women opted for facility based delivery; private facilities are the priority choice. 61.7% women initiated the contraceptive use in last two years (after the project).Use of family planning was increased irrespective of education level and poverty index- about 55.5% women with no formal education are using any form of contraception and trend of current modern contraceptives across poverty scores strata equally distributed amongst all groups. Age specific modern contraceptive prevalence rate (mCPR)(between 25-34) was found to be 43.8%. About 23% of this contraceptive ascertained from door to door services- short acting, (pills and condoms) are common, 29.5% from public facilities and 47.6% are from public facilities in which long acting and permanent method most received methods. Conclusion: Strategy of expanding access and choice in the form of providing family planning information and supplies at door step and availability of quality family planning services in the peripheries of underserved may improve the behavior of women regarding FP/RH.

Keywords: access, family planning, underserved population, socio-demographic facts

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951 Investigation of Municipal Solid Waste Incineration Filter Cake as Minor Additional Constituent in Cement Production

Authors: Veronica Caprai, Katrin Schollbach, Miruna V. A. Florea, H. J. H. Brouwers

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Nowadays MSWI (Municipal Solid Waste Incineration) bottom ash (BA) produced by Waste-to-Energy (WtE) plants represents the majority of the solid residues derived from MSW incineration. Once processed, the BA is often landfilled resulting in possible environmental problems, additional costs for the plant and increasing occupation of public land. In order to limit this phenomenon, European countries such as the Netherlands aid the utilization of MSWI BA in the construction field, by providing standards about the leaching of contaminants into the environment (Dutch Soil Quality Decree). Commonly, BA has a particle size below 32 mm and a heterogeneous chemical composition, depending on its source. By washing coarser BA, an MSWI sludge is obtained. It is characterized by a high content of heavy metals, chlorides, and sulfates as well as a reduced particle size (below 0.25 mm). To lower its environmental impact, MSWI sludge is filtered or centrifuged for removing easily soluble contaminants, such as chlorides. However, the presence of heavy metals is not easily reduced, compromising its possible application. For lowering the leaching of those contaminants, the use of MSWI residues in combination with cement represents a precious option, due to the known retention of those ions into the hydrated cement matrix. Among the applications, the European standard for common cement EN 197-1:1992 allows the incorporation of up to 5% by mass of a minor additional constituent (MAC), such as fly ash or blast furnace slag but also an unspecified filler into cement. To the best of the author's knowledge, although it is widely available, it has the appropriate particle size and a chemical composition similar to cement, FC has not been investigated as possible MAC in cement production. Therefore, this paper will address the suitability of MSWI FC as MAC for CEM I 52.5 R, within a 5% maximum replacement by mass. After physical and chemical characterization of the raw materials, the crystal phases of the pastes are determined by XRD for 3 replacement levels (1%, 3%, and 5%) at different ages. Thereafter, the impact of FC on mechanical and environmental performances of cement is assessed according to EN 196-1 and the Dutch Soil Quality Decree, respectively. The investigation of the reaction products evidences the formation of layered double hydroxides (LDH), in the early stage of the reaction. Mechanically the presence of FC results in a reduction of 28 days compressive strength by 8% for a replacement of 5% wt., compared with the pure CEM I 52.5 R without any MAC. In contrast, the flexural strength is not affected by the presence of FC. Environmentally, the Dutch legislation for the leaching of contaminants for unshaped (granular) material is satisfied. Based on the collected results, FC represents a suitable candidate as MAC in cement production.

Keywords: environmental impact evaluation, Minor additional constituent, MSWI residues, X-ray diffraction crystallography

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950 Rational Approach to Analysis and Construction of Curved Composite Box Girders in Bridges

Authors: Dongming Feng, Fangyin Zhang, Liling Cao

Abstract:

Horizontally curved steel-concrete composite box girders are extensively used in highway bridges. They consist of reinforced concrete deck on top of prefabricated steel box section beam which exhibits a high torsional rigidity to resist torsional effects induced by the curved structural geometry. This type of structural system is often constructed in two stages. The composite section will take the tension mainly by the steel box and, the compression by the concrete deck. The steel girders are delivered in large pre-fabricated U-shaped sections that are designed for ease of construction. They are then erected on site and overlaid by cast-in-place reinforced concrete deck. The functionality of the composite section is not achieved until the closed section is formed by fully cured concrete. Since this kind of composite section is built in two stages, the erection of the open steel box presents some challenges to contractors. When the reinforced concrete slab is cast-in-place, special care should be taken on bracings that can prevent the open U-shaped steel box from global and local buckling. In the case of multiple steel boxes, the design detailing should pay enough attention to the installation requirement of the bracings connecting adjacent steel boxes to prevent the global buckling. The slope in transverse direction and grade in longitudinal direction will result in some local deformation of the steel boxes that affect the connection of the bracings. During the design phase, it is common for engineers to model the curved composite box girder using one-dimensional beam elements. This is adequate to analyze the global behavior, however, it is unable to capture the local deformation which affects the installation of the field bracing connection. The presence of the local deformation may become a critical component to control the construction tolerance, and overlooking this deformation will produce inadequate structural details that eventually cause misalignment in field and erection failure. This paper will briefly describe the construction issues we encountered in real structures, investigate the difference between beam element modeling and shell/solid element modeling, and their impact on the different construction stages. P-delta effect due to the slope and curvature of the composite box girder is analyzed, and the secondary deformation is compared to the first-order response and evaluated for its impact on installation of lateral bracings. The paper will discuss the rational approach to prepare construction documents and recommendations are made on the communications between engineers, erectors, and fabricators to smooth out construction process.

Keywords: buckling, curved composite box girder, stage construction, structural detailing

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949 Investigation of a Technology Enabled Model of Home Care: the eShift Model of Palliative Care

Authors: L. Donelle, S. Regan, R. Booth, M. Kerr, J. McMurray, D. Fitzsimmons

Abstract:

Palliative home health care provision within the Canadian context is challenged by: (i) a shortage of registered nurses (RN) and RNs with palliative care expertise, (ii) an aging population, (iii) reliance on unpaid family caregivers to sustain home care services with limited support to conduct this ‘care work’, (iv) a model of healthcare that assumes client self-care, and (v) competing economic priorities. In response, an interprofessional team of service provider organizations, a software/technology provider, and health care providers developed and implemented a technology-enabled model of home care, the eShift model of palliative home care (eShift). The eShift model combines communication and documentation technology with non-traditional utilization of health human resources to meet patient needs for palliative care in the home. The purpose of this study was to investigate the structure, processes, and outcomes of the eShift model of care. Methodology: Guided by Donebedian’s evaluation framework for health care, this qualitative-descriptive study investigated the structure, processes, and outcomes care of the eShift model of palliative home care. Interviews and focus groups were conducted with health care providers (n= 45), decision-makers (n=13), technology providers (n=3) and family care givers (n=8). Interviews were recorded, transcribed, and a deductive analysis of transcripts was conducted. Study Findings (1) Structure: The eShift model consists of a remotely-situated RN using technology to direct care provision virtually to patients in their home. The remote RN is connected virtually to a health technician (an unregulated care provider) in the patient’s home using real-time communication. The health technician uses a smartphone modified with the eShift application and communicates with the RN who uses a computer with the eShift application/dashboard. Documentation and communication about patient observations and care activities occur in the eShift portal. The RN is typically accountable for four to six health technicians and patients over an 8-hour shift. The technology provider was identified as an important member of the healthcare team. Other members of the team include family members, care coordinators, nurse practitioners, physicians, and allied health. (2) Processes: Conventionally, patient needs are the focus of care; however within eShift, the patient and the family caregiver were the focus of care. Enhanced medication administration was seen as one of the most important processes, and family caregivers reported high satisfaction with the care provided. There was perceived enhanced teamwork among health care providers. (3) Outcomes: Patients were able to die at home. The eShift model enabled consistency and continuity of care, and effective management of patient symptoms and caregiver respite. Conclusion: More than a technology solution, the eShift model of care was viewed as transforming home care practice and an innovative way to resolve the shortage of palliative care nurses within home care.

Keywords: palliative home care, health information technology, patient-centred care, interprofessional health care team

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948 Comparing Remote Sensing and in Situ Analyses of Test Wheat Plants as Means for Optimizing Data Collection in Precision Agriculture

Authors: Endalkachew Abebe Kebede, Bojin Bojinov, Andon Vasilev Andonov, Orhan Dengiz

Abstract:

Remote sensing has a potential application in assessing and monitoring the plants' biophysical properties using the spectral responses of plants and soils within the electromagnetic spectrum. However, only a few reports compare the performance of different remote sensing sensors against in-situ field spectral measurement. The current study assessed the potential applications of open data source satellite images (Sentinel 2 and Landsat 9) in estimating the biophysical properties of the wheat crop on a study farm found in the village of OvchaMogila. A Landsat 9 (30 m resolution) and Sentinel-2 (10 m resolution) satellite images with less than 10% cloud cover have been extracted from the open data sources for the period of December 2021 to April 2022. An Unmanned Aerial Vehicle (UAV) has been used to capture the spectral response of plant leaves. In addition, SpectraVue 710s Leaf Spectrometer was used to measure the spectral response of the crop in April at five different locations within the same field. The ten most common vegetation indices have been selected and calculated based on the reflectance wavelength range of remote sensing tools used. The soil samples have been collected in eight different locations within the farm plot. The different physicochemical properties of the soil (pH, texture, N, P₂O₅, and K₂O) have been analyzed in the laboratory. The finer resolution images from the UAV and the Leaf Spectrometer have been used to validate the satellite images. The performance of different sensors has been compared based on the measured leaf spectral response and the extracted vegetation indices using the five sampling points. A scatter plot with the coefficient of determination (R2) and Root Mean Square Error (RMSE) and the correlation (r) matrix prepared using the corr and heatmap python libraries have been used for comparing the performance of Sentinel 2 and Landsat 9 VIs compared to the drone and SpectraVue 710s spectrophotometer. The soil analysis revealed the study farm plot is slightly alkaline (8.4 to 8.52). The soil texture of the study farm is dominantly Clay and Clay Loam.The vegetation indices (VIs) increased linearly with the growth of the plant. Both the scatter plot and the correlation matrix showed that Sentinel 2 vegetation indices have a relatively better correlation with the vegetation indices of the Buteo dronecompared to the Landsat 9. The Landsat 9 vegetation indices somewhat align better with the leaf spectrometer. Generally, the Sentinel 2 showed a better performance than the Landsat 9. Further study with enough field spectral sampling and repeated UAV imaging is required to improve the quality of the current study.

Keywords: landsat 9, leaf spectrometer, sentinel 2, UAV

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947 Stability Analysis of Hossack Suspension Systems in High Performance Motorcycles

Authors: Ciro Moreno-Ramirez, Maria Tomas-Rodriguez, Simos A. Evangelou

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A motorcycle's front end links the front wheel to the motorcycle's chassis and has two main functions: the front wheel suspension and the vehicle steering. Up to this date, several suspension systems have been developed in order to achieve the best possible front end behavior, being the telescopic fork the most common one and already subjected to several years of study in terms of its kinematics, dynamics, stability and control. A motorcycle telescopic fork suspension model consists of a couple of outer tubes which contain the suspension components (coil springs and dampers) internally and two inner tubes which slide into the outer ones allowing the suspension travel. The outer tubes are attached to the frame through two triple trees which connect the front end to the main frame through the steering bearings and allow the front wheel to turn about the steering axis. This system keeps the front wheel's displacement in a straight line parallel to the steering axis. However, there exist alternative suspension designs that allow different trajectories of the front wheel with the suspension travel. In this contribution, the authors investigate an alternative front suspension system (Hossack suspension) and its influence on the motorcycle nonlinear dynamics to identify and reduce stability risks that a new suspension systems may introduce in the motorcycle dynamics. Based on an existing high-fidelity motorcycle mathematical model, the front end geometry is modified to accommodate a Hossack suspension system. It is characterized by a double wishbone design that varies the front end geometry on certain maneuverings and, consequently, the machine's behavior/response. It consists of a double wishbone structure directly attached to the chassis. In here, the kinematics of this system and its impact on the motorcycle performance/stability are analyzed and compared to the well known telescopic fork suspension system. The framework of this research is the mathematical modelling and numerical simulation. Full stability analyses are performed in order to understand how the motorcycle dynamics may be affected by the newly introduced front end design. This study is carried out by a combination of nonlinear dynamical simulation and root-loci methods. A modal analysis is performed in order to get a deeper understanding of the different modes of oscillation and how the Hossack suspension system affects them. The results show that different kinematic designs of a double wishbone suspension systems do not modify the general motorcycle's stability. The normal modes properties remain unaffected by the new geometrical configurations. However, these normal modes differ from one suspension system to the other. It is seen that the normal modes behaviour depends on various important dynamic parameters, such as the front frame flexibility, the steering damping coefficient and the centre of mass location.

Keywords: nonlinear mechanical systems, motorcycle dynamics, suspension systems, stability

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946 Process Safety Management Digitalization via SHEQTool based on Occupational Safety and Health Administration and Center for Chemical Process Safety, a Case Study in Petrochemical Companies

Authors: Saeed Nazari, Masoom Nazari, Ali Hejazi, Siamak Sanoobari Ghazi Jahani, Mohammad Dehghani, Javad Vakili

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More than ever, digitization is an imperative for businesses to keep their competitive advantages, foster innovation and reduce paperwork. To design and successfully implement digital transformation initiatives within process safety management system, employees need to be equipped with the right tool, frameworks, and best practices. we developed a unique full stack application so-called SHEQTool which is entirely dynamic based on our extensive expertise, experience, and client feedback to help business processes particularly operations safety management. We use our best knowledge and scientific methodologies published by CCPS and OSHA Guidelines to streamline operations and integrated them into task management within Petrochemical Companies. We digitalize their main process safety management system elements and their sub elements such as hazard identification and risk management, training and communication, inspection and audit, critical changes management, contractor management, permit to work, pre-start-up safety review, incident reporting and investigation, emergency response plan, personal protective equipment, occupational health, and action management in a fully customizable manner with no programming needs for users. We review the feedback from main actors within petrochemical plant which highlights improving their business performance and productivity as well as keep tracking their functions’ key performance indicators (KPIs) because it; 1) saves time, resources, and costs of all paperwork on our businesses (by Digitalization); 2) reduces errors and improve performance within management system by covering most of daily software needs of the organization and reduce complexity and associated costs of numerous tools and their required training (One Tool Approach); 3) focuses on management systems and integrate functions and put them into traceable task management (RASCI and Flowcharting); 4) helps the entire enterprise be resilient to any change of your processes, technologies, assets with minimum costs (through Organizational Resilience); 5) reduces significantly incidents and errors via world class safety management programs and elements (by Simplification); 6) gives the companies a systematic, traceable, risk based, process based, and science based integrated management system (via proper Methodologies); 7) helps business processes complies with ISO 9001, ISO 14001, ISO 45001, ISO 31000, best practices as well as legal regulations by PDCA approach (Compliance).

Keywords: process, safety, digitalization, management, risk, incident, SHEQTool, OSHA, CCPS

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945 Fe3O4 Decorated ZnO Nanocomposite Particle System for Waste Water Remediation: An Absorptive-Photocatalytic Based Approach

Authors: Prateek Goyal, Archini Paruthi, Superb K. Misra

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Contamination of water resources has been a major concern, which has drawn attention to the need to develop new material models for treatment of effluents. Existing conventional waste water treatment methods remain ineffective sometimes and uneconomical in terms of remediating contaminants like heavy metal ions (mercury, arsenic, lead, cadmium and chromium); organic matter (dyes, chlorinated solvents) and high salt concentration, which makes water unfit for consumption. We believe that nanotechnology based strategy, where we use nanoparticles as a tool to remediate a class of pollutants would prove to be effective due to its property of high surface area to volume ratio, higher selectivity, sensitivity and affinity. In recent years, scientific advancement has been made to study the application of photocatalytic (ZnO, TiO2 etc.) nanomaterials and magnetic nanomaterials in remediating contaminants (like heavy metals and organic dyes) from water/wastewater. Our study focuses on the synthesis and monitoring remediation efficiency of ZnO, Fe3O4 and Fe3O4 coated ZnO nanoparticulate system for the removal of heavy metals and dyes simultaneously. Multitude of ZnO nanostructures (spheres, rods and flowers) using multiple routes (microwave & hydrothermal approach) offers a wide range of light active photo catalytic property. The phase purity, morphology, size distribution, zeta potential, surface area and porosity in addition to the magnetic susceptibility of the particles were characterized by XRD, TEM, CPS, DLS, BET and VSM measurements respectively. Further on, the introduction of crystalline defects into ZnO nanostructures can also assist in light activation for improved dye degradation. Band gap of a material and its absorbance is a concrete indicator for photocatalytic activity of the material. Due to high surface area, high porosity and affinity towards metal ions and availability of active surface sites, iron oxide nanoparticles show promising application in adsorption of heavy metal ions. An additional advantage of having magnetic based nanocomposite is, it offers magnetic field responsive separation and recovery of the catalyst. Therefore, we believe that ZnO linked Fe3O4 nanosystem would be efficient and reusable. Improved photocatalytic efficiency in addition to adsorption for environmental remediation has been a long standing challenge, and the nano-composite system offers the best of features which the two individual metal oxides provide for nanoremediation.

Keywords: adsorption, nanocomposite, nanoremediation, photocatalysis

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944 Numerical Simulation of the Heat Transfer Process in a Double Pipe Heat Exchanger

Authors: J. I. Corcoles, J. D. Moya-Rico, A. Molina, J. F. Belmonte, J. A. Almendros-Ibanez

Abstract:

One of the most common heat exchangers technology in engineering processes is the use of double-pipe heat exchangers (DPHx), mainly in the food industry. To improve the heat transfer performance, several passive geometrical devices can be used, such as the wall corrugation of tubes, which increases the wet perimeter maintaining a constant cross-section area, increasing consequently the convective surface area. It contributes to enhance heat transfer in forced convection, promoting secondary recirculating flows. One of the most extended tools to analyse heat exchangers' efficiency is the use of computational fluid dynamic techniques (CFD), a complementary activity to the experimental studies as well as a previous step for the design of heat exchangers. In this study, a double pipe heat exchanger behaviour with two different inner tubes, smooth and spirally corrugated tube, have been analysed. Hence, experimental analysis and steady 3-D numerical simulations using the commercial code ANSYS Workbench v. 17.0 are carried out to analyse the influence of geometrical parameters for spirally corrugated tubes at turbulent flow. To validate the numerical results, an experimental setup has been used. To heat up or cool down the cold fluid as it passes through the heat exchanger, the installation includes heating and cooling loops served by an electric boiler with a heating capacity of 72 kW and a chiller, with a cooling capacity of 48 kW. Two tests have been carried out for the smooth tube and for the corrugated one. In all the tests, the hot fluid has a constant flowrate of 50 l/min and inlet temperature of 59.5°C. For the cold fluid, the flowrate range from 25 l/min (Test 1) and 30 l/min (Test 2) with an inlet temperature of 22.1°C. The heat exchanger is made of stainless steel, with an external diameter of 35 mm and wall thickness of 1.5 mm. Both inner tubes have an external diameter of 24 mm and 1 mm thickness of stainless steel with a length of 2.8 m. The corrugated tube has a corrugation height (H) of 1.1 mm and helical pitch (P) of 25 mm. It is characterized using three non-dimensional parameters, the ratio of the corrugation shape and the diameter (H/D), the helical pitch (P/D) and the severity index (SI = H²/P x D). The results showed good agreement between the numerical and the experimental results. Hence, the lowest differences were shown for the fluid temperatures. In all the analysed tests and for both analysed tubes, the temperature obtained numerically was slightly higher than the experimental results, with values ranged between 0.1% and 0.7%. Regarding the pressure drop, the maximum differences between the values obtained numerically, and the experimental values were close to 16%. Based on the experimental and the numerical results, for the corrugated tube, it can be highlighted that the temperature difference between the inlet and the outlet of the cold fluid is 42%, higher than the smooth tube.

Keywords: corrugated tube, heat exchanger, heat transfer, numerical simulation

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943 Hypoglossal Nerve Stimulation (Baseline vs. 12 months) for Obstructive Sleep Apnea: A Meta-Analysis

Authors: Yasmeen Jamal Alabdallat, Almutazballlah Bassam Qablan, Hamza Al-Salhi, Salameh Alarood, Ibraheem Alkhawaldeh, Obada Abunar, Adam Abdallah

Abstract:

Obstructive sleep apnea (OSA) is a disorder caused by the repeated collapse of the upper airway during sleep. It is the most common cause of sleep-related breathing disorder, as OSA can cause loud snoring, daytime fatigue, or more severe problems such as high blood pressure, cardiovascular disease, coronary artery disease, insulin-resistant diabetes, and depression. The hypoglossal nerve stimulator (HNS) is an implantable medical device that reduces the occurrence of obstructive sleep apnea by electrically stimulating the hypoglossal nerve in rhythm with the patient's breathing, causing the tongue to move. This stimulation helps keep the patient's airways clear while they sleep. This systematic review and meta-analysis aimed to assess the clinical outcome of hypoglossal nerve stimulation as a treatment of obstructive sleep apnea. A computer literature search of PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials was conducted from inception until August 2022. Studies assessing the following clinical outcomes (Apnea-Hypopnea Index (AHI), Epworth Sleepiness Scale (ESS), Functional Outcomes of Sleep Questionnaire (FOSQ), Oxygen Desaturation Indices (ODI), (Oxygen Saturation (SaO2)) were pooled in the meta-analysis using Review Manager Software. We assessed the quality of studies according to the Cochrane risk-of-bias tool for randomized trials (RoB2), Risk of Bias In Non-randomized Studies - of Interventions (ROBINS-I), and a modified version of NOS for the non-comparative cohort studies.13 Studies (Six Clinical Trials and Seven prospective cohort studies) with a total of 817 patients were included in the meta-analysis. The results of AHI were reported in 11 studies examining OSA 696 patients. We found that there was a significant improvement in the AHI after 12 months of HNS (MD = 18.2 with 95% CI, (16.7 to 19.7; I2 = 0%); P < 0.00001). Further, 12 studies reported the results of ESS after 12 months of intervention with a significant improvement in the range of sleepiness among the examined 757 OSA patients (MD = 5.3 with 95% CI, (4.75 to 5.86; I2 = 65%); P < 0.0001). Moreover, nine studies involving 699 participants reported the results of FOSQ after 12 months of HNS with a significant reported improvement (MD = -3.09 with 95% CI, (-3.41 to 2.77; I2 = 0%); P < 0.00001). In addition, ten studies reported the results of ODI with a significant improvement after 12 months of HNS among the 817 examined patients (MD = 14.8 with 95% CI, (13.25 to 16.32; I2 = 0%); P < 000001). The Hypoglossal Nerve Stimulation showed a significant positive impact on obstructive sleep apnea patients after 12 months of therapy in terms of apnea-hypopnea index, oxygen desaturation indices, manifestations of the behavioral morbidity associated with obstructive sleep apnea, and functional status resulting from sleepiness.

Keywords: apnea, meta-analysis, hypoglossal, stimulation

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942 Metacognitive Processing in Early Readers: The Role of Metacognition in Monitoring Linguistic and Non-Linguistic Performance and Regulating Students' Learning

Authors: Ioanna Taouki, Marie Lallier, David Soto

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Metacognition refers to the capacity to reflect upon our own cognitive processes. Although there is an ongoing discussion in the literature on the role of metacognition in learning and academic achievement, little is known about its neurodevelopmental trajectories in early childhood, when children begin to receive formal education in reading. Here, we evaluate the metacognitive ability, estimated under a recently developed Signal Detection Theory model, of a cohort of children aged between 6 and 7 (N=60), who performed three two-alternative-forced-choice tasks (two linguistic: lexical decision task, visual attention span task, and one non-linguistic: emotion recognition task) including trial-by-trial confidence judgements. Our study has three aims. First, we investigated how metacognitive ability (i.e., how confidence ratings track accuracy in the task) relates to performance in general standardized tasks related to students' reading and general cognitive abilities using Spearman's and Bayesian correlation analysis. Second, we assessed whether or not young children recruit common mechanisms supporting metacognition across the different task domains or whether there is evidence for domain-specific metacognition at this early stage of development. This was done by examining correlations in metacognitive measures across different task domains and evaluating cross-task covariance by applying a hierarchical Bayesian model. Third, using robust linear regression and Bayesian regression models, we assessed whether metacognitive ability in this early stage is related to the longitudinal learning of children in a linguistic and a non-linguistic task. Notably, we did not observe any association between students’ reading skills and metacognitive processing in this early stage of reading acquisition. Some evidence consistent with domain-general metacognition was found, with significant positive correlations between metacognitive efficiency between lexical and emotion recognition tasks and substantial covariance indicated by the Bayesian model. However, no reliable correlations were found between metacognitive performance in the visual attention span and the remaining tasks. Remarkably, metacognitive ability significantly predicted children's learning in linguistic and non-linguistic domains a year later. These results suggest that metacognitive skill may be dissociated to some extent from general (i.e., language and attention) abilities and further stress the importance of creating educational programs that foster students’ metacognitive ability as a tool for long term learning. More research is crucial to understand whether these programs can enhance metacognitive ability as a transferable skill across distinct domains or whether unique domains should be targeted separately.

Keywords: confidence ratings, development, metacognitive efficiency, reading acquisition

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941 Environmental and Formal Conditions for the Development of Blue-green Infrastructure (BGI) in the Cities of Central Europe on the Example of Poland

Authors: Magdalena Biela, Marta Weber-Siwirska, Edyta Sierka

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The current noticed trend in Central European countries, as in other regions of the world, is for people to migrate to cities. As a result, the urban population is to have reached 70% of the total by 2050. Due to this tendency, as well as taking high real estate prices and limited reserves of city green areas into consideration, the greenery and agricultural soil adjacent to cities is are to be devoted to housing projects, while city centres are expected to undergo partial depopulation. Urban heat islands and phenomena such as torrential rains may cause serious damage. They may even endanger the very life and health of the inhabitants. Due to these tangible effects of climate change, residents expect that local government takes action to develop green infrastructure (GI). The main purpose of our research has been to assess the degree of readiness on the part of the local government in Poland to develop BGI. A questionnaire using the CAWI method was prepared, and a survey was carried out. The target group were town hall employees in all 380 powiat cities and towns (380 county centres) in Poland. The form contained 14 questions covering, among others, actions taken to support the development of GI and ways of motivating residents to take such actions. 224 respondents replied to the questions. The results of the research show that 52% of the cities/towns have taken or intend to take measures to favour the development of green spaces. Currently, the installation of green roofs and living walls is are only carried out by 6 Polish cities, and a few more are at the stage of preparing appropriate regulations. The problem of rainwater retention is much more widespread. Among the municipalities declaring any activities for the benefit of GI, approximately 42% have decided to work on this problem. Over 19% of the respondents are planning an increase in the surface occupied by green areas, 14% - the installation of green roofs, and 12% - redevelopment of city greenery. It is optimistic that 67% of the respondents are willing to acquire knowledge about BGI by means of taking part in educational activities both at the national and international levels. There are many ways to help GI development. The most common type of support in the cities and towns surveyed is co-financing (35%), followed by full financing of projects (11%). About 15% of the cities declare only advisory support. Thus, the problem of GI in Central European cities is at the stage of initial development and requires advanced measures and implementation of both proven solutions applied in other European and world countries using the concept of Nature-based Solutions.

Keywords: city/town, blue-green infrastructure, green roofs, climate change adaptation

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940 Influence of a Cationic Membrane in a Double Compartment Filter-Press Reactor on the Atenolol Electro-Oxidation

Authors: Alan N. A. Heberle, Salatiel W. Da Silva, Valentin Perez-Herranz, Andrea M. Bernardes

Abstract:

Contaminants of emerging concern are substances widely used, such as pharmaceutical products. These compounds represent risk for both wild and human life since they are not completely removed from wastewater by conventional wastewater treatment plants. In the environment, they can be harm even in low concentration (µ or ng/L), causing bacterial resistance, endocrine disruption, cancer, among other harmful effects. One of the most common taken medicine to treat cardiocirculatory diseases is the Atenolol (ATL), a β-Blocker, which is toxic to aquatic life. In this way, it is necessary to implement a methodology, which is capable to promote the degradation of the ATL, to avoid the environmental detriment. A very promising technology is the advanced electrochemical oxidation (AEO), which mechanisms are based on the electrogeneration of reactive radicals (mediated oxidation) and/or on the direct substance discharge by electron transfer from contaminant to electrode surface (direct oxidation). The hydroxyl (HO•) and sulfate (SO₄•⁻) radicals can be generated, depending on the reactional medium. Besides that, at some condition, the peroxydisulfate (S₂O₈²⁻) ion is also generated from the SO₄• reaction in pairs. Both radicals, ion, and the direct contaminant discharge can break down the molecule, resulting in the degradation and/or mineralization. However, ATL molecule and byproducts can still remain in the treated solution. On this wise, some efforts can be done to implement the AEO process, being one of them the use of a cationic membrane to separate the cathodic (reduction) from the anodic (oxidation) reactor compartment. The aim of this study is investigate the influence of the implementation of a cationic membrane (Nafion®-117) to separate both cathodic and anodic, AEO reactor compartments. The studied reactor was a filter-press, with bath recirculation mode, flow 60 L/h. The anode was an Nb/BDD2500 and the cathode a stainless steel, both bidimensional, geometric surface area 100 cm². The solution feeding the anodic compartment was prepared with ATL 100 mg/L using Na₂SO₄ 4 g/L as support electrolyte. In the cathodic compartment, it was used a solution containing Na₂SO₄ 71 g/L. Between both solutions was placed the membrane. The applied currents densities (iₐₚₚ) of 5, 20 and 40 mA/cm² were studied over 240 minutes treatment time. Besides that, the ATL decay was analyzed by ultraviolet spectroscopy (UV/Vis). The mineralization was determined performing total organic carbon (TOC) in TOC-L CPH Shimadzu. In the cases without membrane, the iₐₚₚ 5, 20 and 40 mA/cm² resulted in 55, 87 and 98 % ATL degradation at the end of treatment time, respectively. However, with membrane, the degradation, for the same iₐₚₚ, was 90, 100 and 100 %, spending 240, 120, 40 min for the maximum degradation, respectively. The mineralization, without membrane, for the same studied iₐₚₚ, was 40, 55 and 72 %, respectively at 240 min, but with membrane, all tested iₐₚₚ reached 80 % of mineralization, differing only in the time spent, 240, 150 and 120 min, for the maximum mineralization, respectively. The membrane increased the ATL oxidation, probably due to avoid oxidant ions (S₂O₈²⁻) reduction on the cathode surface.

Keywords: contaminants of emerging concern, advanced electrochemical oxidation, atenolol, cationic membrane, double compartment reactor

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939 Prevalence of Behavioral and Emotional Problems in School Going Adolescents in India

Authors: Anshu Gupta, Charu Gupta

Abstract:

Background: Adolescence is the transitional period between puberty and adulthood. It is marked by immense turmoil in emotional and behavioral spheres. Adolescents are at risk of an array of behavioral and emotional problems, resulting in social, academic and vocational function impairments. Conflicts in the family and inability of the parents to cope with the changing demands of an adolescent have a negative impact on the overall development of the child. This augers ill for the individual’s future, resulting in depression, delinquency and suicides among other problems. Aim: The aim of the study was to compare the prevalence of behavioral and emotional problems in school going adolescents aged 13 to 15 years residing in Ludhiana city. Method: A total of 1380 school children in the age group of 13 to 15 years were assessed by the adolescent health screening questionnaire (FAPS) and Youth Self-Report (2001) questionnaire. Statistical significance was ascertained by t-test, chi-square test (x²) and ANOVA, as appropriate. Results: A considerably high prevalence of behavioral and emotional problems was found in school going adolescents (26.5%), more in girls (31.7%) than in boys (24.4%). In case of boys, the maximum problem was in the 13 year age group, i.e., 28.2%, followed by a significant decline by the age of 14 years, i.e., 24.2% and 15 years, i.e., 19.6%. In case of girls also, the maximum problem was in the 13 year age group, i.e., 32.4% followed by a marginal decline in the 14 years i.e., 31.8% and 15 year age group, i.e., 30.2%. Demographic factors were non contributory. Internalizing syndrome (22.4%) was the most common problem followed by the neither internalizing nor externalizing (17.6%) group. In internalizing group, most (26.5%) of the students were observed to be anxious/ depressed. Social problem was observed to be the most frequent (10.6%) among neither internalizing nor externalizing group. Aggressive behavior was the commonest (8.4%) among externalizing group. Internalizing problems, mainly anxiety and depression, were commoner in females (30.6%) than males (24.6%). More boys (16%) than girls (13.4%) were reported to suffer from externalizing disorders. A critical review of the data showed that most of the adolescents had poor knowledge about reproductive health. Almost 36% reported that the source of their information on sexual and reproductive health being friends and the electronic media. There was a high percentage of adolescents who reported being worried about sexual abuse (20.2%) with majority of them being girls (93.6%) reflecting poorly on the social setup in the country. About 41% of adolescents reported being concerned about body weight and most of them being girls (92.4%). Up to 14.5% reported having thoughts of using alcohol or drugs perhaps due to the easy availability of substances of abuse in this part of the country. 12.8% (mostly girls) reported suicidal thoughts. Summary/conclusion: There is a high prevalence of emotional and behavioral problems among school-going adolescents. Resolution of these problems during adolescence is essential for attaining a healthy adulthood. The need of the hour is to spread awareness among caregivers and formulation of effective management strategies including school mental health programme.

Keywords: adolescence, behavioral, emotional, internalizing problem

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938 Augusto De Campos Translator: The Role of Translation in Brazilian Concrete Poetry Project

Authors: Juliana C. Salvadori, Jose Carlos Felix

Abstract:

This paper aims at discussing the role literary translation has played in Brazilian Concrete Poetry Movement – an aesthetic, critical and pedagogical project which conceived translation as poiesis, i.e., as both creative and critic work in which the potency (dynamic) of literary work is unfolded in the interpretive and critic act (energeia) the translating practice demands. We argue that translation, for concrete poets, is conceived within the framework provided by the reinterpretation –or deglutition– of Oswald de Andrade’s anthropophagy – a carefully selected feast from which the poets pick and model their Paideuma. As a case study, we propose to approach and analyze two of Augusto de Campos’s long-term translation projects: the translation of Emily Dickinson’s and E. E. Cummings’s works to Brazilian readers. Augusto de Campos is a renowned poet, translator, critic and one of the founding members of Brazilian Concrete Poetry movement. Since the 1950s he has produced a consistent body of translated poetry from English-speaking poets in which the translator has explored creative translation processes – transcreation, as concrete poets have named it. Campos’s translation project regarding E. E. Cummings’s poetry comprehends a span of forty years: it begins in 1956 with 10 poems and unfolds in 4 works – 20 poem(a)s, 40 poem(a)s, Poem(a)s, re-edited in 2011. His translations of Dickinson’s poetry are published in two works: O Anticrítico (1986), in which he translated 10 poems, and Emily Dickinson Não sou Ninguém (2008), in which the poet-translator added 35 more translated poems. Both projects feature bilingual editions: contrary to common sense, Campos translations aim at being read as such: the target readers, to fully enjoy the experience, must be proficient readers of English and, also, acquainted with the poets in translation – Campos expects us to perform translation criticism, as Antoine Berman has proposed, by assessing the choices he, as both translator and poet, has presented in order to privilege aesthetic information (verse lines, word games, etc.). To readers not proficient in English, his translations play a pedagogycal role of educating and preparing them to read both the target poet works as well as concrete poetry works – the detailed essays and prefaces in which the translator emphasizes the selection of works translated and strategies adopted enlighten his project as translator: for Cummings, it has led to the oblieraton of the more traditional and lyrical/romantic examples of his poetry while highlighting the more experimental aspects and poems; for Dickinson, his project has highligthed the more hermetic traits of her poems. To the domestic canons of both poets in Brazilian literary system, we analyze Campos’ contribution in this work.

Keywords: translation criticism, Augusto de Campos, E. E. Cummings, Emily Dickinson

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937 The Problems of Women over 65 with Incontinence Diagnosis: A Case Study in Turkey

Authors: Birsel Canan Demirbag, Kıymet Yesilcicek Calik, Hacer Kobya Bulut

Abstract:

Objective: This study was conducted to evaluate the problems of women over 65 with incontinence diagnosis. Methods: This descriptive study was conducted with women over 65 with incontinence diagnosis in four Family Health Centers in a city in Eastern Black Sea region between November 1, and December 20, 2015. 203, 107, 178, 180 women over 65 were registered in these centers and 262 had incontinence diagnosis at least once and had an ongoing complaint. 177 women were volunteers for the study. During home visits and using face-to-face survey methodology, participants were given socio-demographic characteristics survey, Sandvik severity scale, Incontinence Quality of Life Scale, Urogenital Distress Inventory and a questionnaire including challenges experienced due to incontinence developed by the researcher. Data were analyzed with SPSS program using percentages, numbers, Chi-square, Man-Whitney U and t test with 95% confidence interval and a significance level p <0.05. Findings: 67 ± 1.4 was the mean age, 2.05 ± 0.04 was parity, 44.5 ± 2.12 was menopause age, 66.3% were primary school graduates, 45.7% had deceased spouse, 44.4% lived in a large family, 67.2% had their own room, 77.8% had income, 89.2% could meet self- care, 73.2% had a diagnosis of mixed incontinence, 87.5% suffered for 6-20 years % 78.2 had diuretics, antidepressants and heart medicines, 20.5% had urinary fecal cases, 80.5% had bladder training at least once, 90.1% didn’t have bladder diary calendar/control training programs, 31.1% had hysterectomy for prolapse, 97.1'i% was treated with lower urinary tract infection at least once, 66.3% saw a doctor to get drug in the last three months, 76.2 could not go out alone, 99.2 % had at least one chronic disease, 87.6 % had constipation complain, 2.9% had chronic cough., 45.1% fell due to a sudden rise for toilet. Incontinence Impact Questionnaire Average score was (QOL) 54.3 ± 21.1, Sandvik score was 12.1 ± 2.5, Urogenital Distress Inventory was 47.7 ± 9.2. Difficulties experienced due to incontinence were 99.5% feeling of unhappiness, 67.1% constant feeling of urine smell due to failing to change briefs frequently, % 87.2 move away from social life, 89.7 unable to use pad, 99.2% feeling of disturbing households / other individuals, 87.5% feel dizziness/fall due to sudden rise, 87.4% feeling of others’ imperceptions about the situation, % 94.3 insomnia, 78.2 lack of assistance, 84.7% couldn’t afford urine protection briefs. Results: With this study, it was found out that there were a lot of unsolved issues at individual and community level affecting the life quality of women with incontinence. In accordance with this common problem in women, to facilitate daily life it is obvious that regular home care training programs at institutional level in our country will be effective.

Keywords: health problems, incontinence, incontinence quality of life questionnaire, old age, urinary urogenital distress inventory, Sandviken severity, women

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936 The Effect of the Construction Contract System by Simulating the Comparative Costs of Capital to the Financial Feasibility of the Construction of Toll Bali Mandara

Authors: Mas Pertiwi I. G. AG Istri, Sri Kristinayanti Wayan, Oka Aryawan I. Gede Made

Abstract:

Ability of government to meet the needs of infrastructure investment constrained by the size of the budget commitments for other sectors. Another barrier is the complexity of the process of land acquisition. Public Private Partnership can help bridge the investment gap by including the amount of funding from the private sector, shifted the responsibility of financing, construction of the asset, and the operation and post-project design and care to them. In principle, a construction project implementation always requires the investor as a party to provide resources in the form of funding which it must be contained in a successor agreement in the form of a contract. In general, construction contracts consist of contracts which passed in Indonesia and contract International. One source of funding used in the implementation of construction projects comes from funding that comes from the collaboration between the government and the private sector, for example with the system: BLT (Build Lease Transfer), BOT (Build Operate Transfer), BTO (Build Transfer Operate) and BOO (Build Operate Own). And form of payment under a construction contract can be distinguished several ways: monthly payment, payments based on progress and payment after completed projects (Turn Key). One of the tools used to analyze the feasibility of the investment is to use financial models. The financial model describes the relationship between different variables and assumptions used. From a financial model will be known how the cash flow structure of the project, which includes revenues, expenses, liabilities to creditors and the payment of taxes to the government. Net cash flow generated from the project will be used as a basis for analyzing the feasibility of investment source of project financing Public Private Partnership could come from equity or debt. The proportion of funding according to its source is a comparison of a number of investment funds originating from each source of financing for a total investment cost during the construction period by selected the contract system and several alternative financing percentage ratio determined according to sources will generate cash flow structure that is different. Of the various possibilities for the structure of the cash flow generated will be analyzed by software is to test T Paired to compared the contract system used by various alternatives comparison of financing to determine the effect of the contract system and the comparison of such financing for the feasibility of investment toll road construction project for the economic life of 20 (twenty) years. In this use case studies of toll road contruction project Bali Mandara. And in this analysis only covered two systems contracts, namely Build Operate Transfer and Turn Key. Based on the results obtained by analysis of the variable investment feasibility of the NPV, BCR and IRR between the contract system Build Operate Transfer and contract system Turn Key on the interest rate of 9%, 12% and 15%.

Keywords: contract system, financing, internal rate of return, net present value

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935 A Study of Applying the Use of Breathing Training to Palliative Care Patients, Based on the Bio-Psycho-Social Model

Authors: Wenhsuan Lee, Yachi Chang, Yingyih Shih

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In clinical practices, it is common that while facing the unknown progress of their disease, palliative care patients may easily feel anxious and depressed. These types of reactions are a cause of psychosomatic diseases and may also influence treatment results. However, the purpose of palliative care is to provide relief from all kinds of pains. Therefore, how to make patients more comfortable is an issue worth studying. This study adopted the “bio-psycho-social model” proposed by Engel and applied spontaneous breathing training, in the hope of seeing patients’ psychological state changes caused by their physiological state changes, improvements in their anxious conditions, corresponding adjustments of their cognitive functions, and further enhancement of their social functions and the social support system. This study will be a one-year study. Palliative care outpatients will be recruited and assigned to the experimental group or the control group for six outpatient visits (once a month), with 80 patients in each group. The patients of both groups agreed that this study can collect their physiological quantitative data using an HRV device before the first outpatient visit. They also agreed to answer the “Beck Anxiety Inventory (BAI)”, the “Taiwanese version of the WHOQOL-BREF questionnaire” before the first outpatient visit, to fill a self-report questionnaire after each outpatient visit, and to answer the “Beck Anxiety Inventory (BAI)”, the “Taiwanese version of the WHOQOL-BREF questionnaire” after the last outpatient visit. The patients of the experimental group agreed to receive the breathing training under HRV monitoring during the first outpatient visit of this study. Before each of the following three outpatient visits, they were required to fill a self-report questionnaire regarding their breathing practices after going home. After the outpatient visits, they were taught how to practice breathing through an HRV device and asked to practice it after going home. Later, based on the results from the HRV data analyses and the pre-tests and post-tests of the “Beck Anxiety Inventory (BAI)”, the “Taiwanese version of the WHOQOL-BREF questionnaire”, the influence of the breathing training in the bio, psycho, and social aspects were evaluated. The data collected through the self-report questionnaires of the patients of both groups were used to explore the possible interfering factors among the bio, psycho, and social changes. It is expected that this study will support the “bio-psycho-social model” proposed by Engel, meaning that bio, psycho, and social supports are closely related, and that breathing training helps to transform palliative care patients’ psychological feelings of anxiety and depression, to facilitate their positive interactions with others, and to improve the quality medical care for them.

Keywords: palliative care, breathing training, bio-psycho-social model, heart rate variability

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934 A Holistic View of Microbial Community Dynamics during a Toxic Harmful Algal Bloom

Authors: Shi-Bo Feng, Sheng-Jie Zhang, Jin Zhou

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The relationship between microbial diversity and algal bloom has received considerable attention for decades. Microbes undoubtedly affect annual bloom events and impact the physiology of both partners, as well as shape ecosystem diversity. However, knowledge about interactions and network correlations among broader-spectrum microbes that lead to the dynamics in a complete bloom cycle are limited. In this study, pyrosequencing and network approaches simultaneously assessed the associate patterns among bacteria, archaea, and microeukaryotes in surface water and sediments in response to a natural dinoflagellate (Alexandrium sp.) bloom. In surface water, among the bacterial community, Gamma-Proteobacteria and Bacteroidetes dominated in the initial bloom stage, while Alpha-Proteobacteria, Cyanobacteria, and Actinobacteria become the most abundant taxa during the post-stage. In the archaea biosphere, it clustered predominantly with Methanogenic members in the early pre-bloom period while the majority of species identified in the later-bloom stage were ammonia-oxidizing archaea and Halobacteriales. In eukaryotes, dinoflagellate (Alexandrium sp.) was dominated in the onset stage, whereas multiply species (such as microzooplankton, diatom, green algae, and rotifera) coexistence in bloom collapse stag. In sediments, the microbial species biomass and richness are much higher than the water body. Only Flavobacteriales and Rhodobacterales showed a slight response to bloom stages. Unlike the bacteria, there are small fluctuations of archaeal and eukaryotic structure in the sediment. The network analyses among the inter-specific associations show that bacteria (Alteromonadaceae, Oceanospirillaceae, Cryomorphaceae, and Piscirickettsiaceae) and some zooplankton (Mediophyceae, Mamiellophyceae, Dictyochophyceae and Trebouxiophyceae) have a stronger impact on the structuring of phytoplankton communities than archaeal effects. The changes in population were also significantly shaped by water temperature and substrate availability (N & P resources). The results suggest that clades are specialized at different time-periods and that the pre-bloom succession was mainly a bottom-up controlled, and late-bloom period was controlled by top-down patterns. Additionally, phytoplankton and prokaryotic communities correlated better with each other, which indicate interactions among microorganisms are critical in controlling plankton dynamics and fates. Our results supplied a wider view (temporal and spatial scales) to understand the microbial ecological responses and their network association during algal blooming. It gives us a potential multidisciplinary explanation for algal-microbe interaction and helps us beyond the traditional view linked to patterns of algal bloom initiation, development, decline, and biogeochemistry.

Keywords: microbial community, harmful algal bloom, ecological process, network

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933 Religious Capital and Entrepreneurial Behavior in Small Businesses: The Importance of Entrepreneurial Creativity

Authors: Waleed Omri

Abstract:

With the growth of the small business sector in emerging markets, developing a better understanding of what drives 'day-to-day' entrepreneurial activities has become an important issue for academicians and practitioners. Innovation, as an entrepreneurial behavior, revolves around individuals who creatively engage in new organizational efforts. In a similar vein, the innovation behaviors and processes at the organizational member level are central to any corporate entrepreneurship strategy. Despite the broadly acknowledged importance of entrepreneurship and innovation at the individual level in the establishment of successful ventures, the literature lacks evidence on how entrepreneurs can effectively harness their skills and knowledge in the workplace. The existing literature illustrates that religion can impact the day-to-day work behavior of entrepreneurs, managers, and employees. Religious beliefs and practices could affect daily entrepreneurial activities by fostering mental abilities and traits such as creativity, intelligence, and self-efficacy. In the present study, we define religious capital as a set of personal and intangible resources, skills, and competencies that emanate from an individual’s religious values, beliefs, practices, and experiences and may be used to increase the quality of economic activities. Religious beliefs and practices give individuals a religious satisfaction, which can lead them to perform better in the workplace. In addition, religious ethics and practices have been linked to various positive employee outcomes in terms of organizational change, job satisfaction, and entrepreneurial intensity. As investigations of their consequences beyond direct task performance are still scarce, we explore if religious capital plays a role in entrepreneurs’ innovative behavior. In sum, this study explores the determinants of individual entrepreneurial behavior by investigating the relationship between religious capital and entrepreneurs’ innovative behavior in the context of small businesses. To further explain and clarify the religious capital-innovative behavior link, the present study proposes a model to examine the mediating role of entrepreneurial creativity. We use both Islamic work ethics (IWE) and Islamic religious practices (IRP) to measure Islamic religious capital. We use structural equation modeling with a robust maximum likelihood estimation to analyze data gathered from 289 Tunisian small businesses and to explore the relationships among the above-described variables. In line with the theory of planned behavior, only religious work ethics are found to increase the innovative behavior of small businesses’ owner-managers. Our findings also clearly demonstrate that the connection between religious capital-related variables and innovative behavior is better understood if the influence of entrepreneurial creativity, as a mediating variable of the aforementioned relationship, is taken into account. By incorporating both religious capital and entrepreneurial creativity into the innovative behavior analysis, this study provides several important practical implications for promoting innovation process in small businesses.

Keywords: entrepreneurial behavior, small business, religion, creativity

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932 Impact of Climatic Hazards on the Jamuna River Fisheries and Coping and Adaptation Strategies

Authors: Farah Islam, Md. Monirul Islam, Mosammat Salma Akter, Goutam Kumar Kundu

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The continuous variability of climate and the risk associated with it have a significant impact on the fisheries leading to a global concern for about half a billion fishery-based livelihoods. Though in the context of Bangladesh mounting evidence on the impacts of climate change on fishery-based livelihoods or their socioeconomic conditions are present, the country’s inland fisheries sector remains in a negligible corner as compared to the coastal areas which are spotted on the highlight due to its higher vulnerability to climatic hazards. The available research on inland fisheries, particularly river fisheries, has focussed mainly on fish production, pollution, fishing gear, fish biodiversity and livelihoods of the fishers. This study assesses the impacts of climate variability and changes on the Jamuna (a transboundary river called Brahmaputra in India) River fishing communities and their coping and adaptation strategies. This study has used primary data collected from Kalitola Ghat and Debdanga fishing communities of the Jamuna River during May, August and December 2015 using semi-structured interviews, oral history interviews, key informant interviews, focus group discussions and impact matrix as well as secondary data. This study has found that both communities are exposed to storms, floods and land erosions which impact on fishery-based livelihood assets, strategies, and outcomes. The impact matrix shows that human and physical capitals are more affected by climate hazards which in turn affect financial capital. Both communities have been responding to these exposures through multiple coping and adaptation strategies. The coping strategies include making dam with soil, putting jute sac on the yard, taking shelter on boat or embankment, making raised platform or ‘Kheua’ and involving with temporary jobs. While, adaptation strategies include permanent migration, change of livelihood activities and strategies, changing fishing practices and making robust houses. The study shows that migration is the most common adaptation strategy for the fishers which resulted in mostly positive outcomes for the migrants. However, this migration has impacted negatively on the livelihoods of existing fishers in the communities. In sum, the Jamuna river fishing communities have been impacted by several climatic hazards and they have traditionally coped with or adapted to the impacts which are not sufficient to maintain sustainable livelihoods and fisheries. In coming decades, this situation may become worse as predicted by latest scientific research and an enhanced level of response would be needed.

Keywords: climatic hazards, impacts and adaptation, fisherfolk, the Jamuna River

Procedia PDF Downloads 302
931 Analysis of Resistance and Virulence Genes of Gram-Positive Bacteria Detected in Calf Colostrums

Authors: C. Miranda, S. Cunha, R. Soares, M. Maia, G. Igrejas, F. Silva, P. Poeta

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The worldwide inappropriate use of antibiotics has increased the emergence of antimicrobial-resistant microorganisms isolated from animals, humans, food, and the environment. To combat this complex and multifaceted problem is essential to know the prevalence in livestock animals and possible ways of transmission among animals and between these and humans. Enterococci species, in particular E. faecalis and E. faecium, are the most common nosocomial bacteria, causing infections in animals and humans. Thus, the aim of this study was to characterize resistance and virulence factors genes among two enterococci species isolated from calf colostrums in Portuguese dairy farms. The 55 enterococci isolates (44 E. faecalis and 11 E. faecium) were tested for the presence of the resistance genes for the following antibiotics: erythromicyn (ermA, ermB, and ermC), tetracycline (tetL, tetM, tetK, and tetO), quinupristin/dalfopristin (vatD and vatE) and vancomycin (vanB). Of which, 25 isolates (15 E. faecalis and 10 E. faecium) were tested until now for 8 virulence factors genes (esp, ace, gelE, agg, cpd, cylA, cylB, and cylLL). The resistance and virulence genes were performed by PCR, using specific primers and conditions. Negative and positive controls were used in all PCR assays. All enterococci isolates showed resistance to erythromicyn and tetracycline through the presence of the genes: ermB (n=29, 53%), ermC (n=10, 18%), tetL (n=49, 89%), tetM (n=39, 71%) and tetK (n=33, 60%). Only two (4%) E. faecalis isolates showed the presence of tetO gene. No resistance genes for vancomycin were found. The virulence genes detected in both species were cpd (n=17, 68%), agg (n=16, 64%), ace (n=15, 60%), esp (n=13, 52%), gelE (n=13, 52%) and cylLL (n=8, 32%). In general, each isolate showed at least three virulence genes. In three E. faecalis isolates was not found virulence genes and only E. faecalis isolates showed virulence genes for cylA (n=4, 16%) and cylB (n=6, 24%). In conclusion, these colostrum samples that were consumed by calves demonstrated the presence of antibiotic-resistant enterococci harbored virulence genes. This genotypic characterization is crucial to control the antibiotic-resistant bacteria through the implementation of restricts measures safeguarding public health. Acknowledgements: This work was funded by the R&D Project CAREBIO2 (Comparative assessment of antimicrobial resistance in environmental biofilms through proteomics - towards innovative theragnostic biomarkers), with reference NORTE-01-0145-FEDER-030101 and PTDC/SAU-INF/30101/2017, financed by the European Regional Development Fund (ERDF) through the Northern Regional Operational Program (NORTE 2020) and the Foundation for Science and Technology (FCT). This work was supported by the Associate Laboratory for Green Chemistry - LAQV which is financed by national funds from FCT/MCTES (UIDB/50006/2020 and UIDP/50006/2020).

Keywords: antimicrobial resistance, calf, colostrums, enterococci

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930 Comparing the Knee Kinetics and Kinematics during Non-Steady Movements in Recovered Anterior Cruciate Ligament Injured Badminton Players against an Uninjured Cohort: Case-Control Study

Authors: Anuj Pathare, Aleksandra Birn-Jeffery

Abstract:

Background: The Anterior Cruciate Ligament(ACL) helps stabilize the knee joint minimizing tibial anterior translation. Anterior Cruciate Ligament (ACL) injury is common in racquet sports and often occurs due to sudden acceleration, deceleration or changes of direction. This mechanism in badminton most commonly occurs during landing after an overhead stroke. Knee biomechanics during dynamic movements such as walking, running and stair negotiation, do not return to normal for more than a year after an ACL reconstruction. This change in the biomechanics may lead to re-injury whilst performing non-steady movements during sports, where these injuries are most prevalent. Aims: To compare if the knee kinetics and kinematics in ACL injury recovered athletes return to the same level as those from an uninjured cohort during standard movements used for clinical assessment and badminton shots. Objectives: The objectives of the study were to determine: Knee valgus during the single leg squat, vertical drop jump, net shot and drop shot; Degree of internal or external rotation during the single leg squat, vertical drop jump, net shot and drop shot; Maximum knee flexion during the single leg squat, vertical drop jump and net shot. Methods: This case-control study included 14 participants with three ACL injury recovered athletes and 11 uninjured participants. The participants performed various functional tasks including vertical drop jump, single leg squat; the forehand net shot and the forehand drop shot. The data was analysed using the two-way ANOVA test, and the reliability of the data was evaluated using the Intra Class Coefficient. Results: The data showed a significant decrease in the range of knee rotation in ACL injured participants as compared to the uninjured cohort (F₇,₅₅₆=2.37; p=0.021). There was also a decrease in the maximum knee flexion angles and an increase in knee valgus angles in ACL injured participants although they were not statistically significant. Conclusion: There was a significant decrease in the knee rotation angles in the ACL injured participants which could be a potential cause for re-injury in these athletes in the future. Although the results for decrease in maximum knee flexion angles and increase in knee valgus angles were not significant, this may be due to a limited sample of ACL injured participants; there is potential for it to be identified as a variable of interest in the rehabilitation of ACL injuries. These changes in the knee biomechanics could be vital in the rehabilitation of ACL injured athletes in the future, and an inclusion of sports based tasks, e.g., Net shot along with standard protocol movements for ACL assessment would provide a better measure of the rehabilitation of the athlete.

Keywords: ACL, biomechanics, knee injury, racquet sport

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929 Prosecution as Persecution: Exploring the Enduring Legacy of Judicial Harassment of Human Rights Defenders and Political Opponents in Zimbabwe, Cases from 2013-2016

Authors: Bellinda R. Chinowawa

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As part of a wider strategy to stifle civil society, Governments routinely resort to judicial harassment through the use of civil and criminal to impugn the integrity of human rights defenders and that of perceived political opponents. This phenomenon is rife in militarised or autocratic regimes where there is no tolerance for dissenting voices. Zimbabwe, ostensibly a presidential republic founded on the values of transparency, equality, freedom, is characterised by brutal suppression of perceived political opponents and those who assert their basic human rights. This is done through a wide range of tactics including unlawful arrests and detention, torture and other cruel, inhuman degrading treatment and enforced disappearances. Professionals including, journalists and doctors are similarly not spared from state attack. For human rights defenders, the most widely used tool of repression is that of judicial harassment where the judicial system is used to persecute them. This can include the levying of criminal charges, civil lawsuits and unnecessary administrative proceedings. Charges preferred against range from petty offences such as criminal nuisance to more serious charges of terrorism and subverting a constitutional government. Additionally, government sponsored individuals and organisations file strategic lawsuits with pecuniary implications order to intimidate and silence critics and engender self-censorship. Some HRDs are convicted and sentenced to prison terms, despite not being criminals in a true sense. While others are acquitted judicial harassment diverts energy and resources away from their human rights work. Through a consideration of statistical data reported by human rights organisations and face to face interviews with a cross section of human rights defenders, the article will map the incidence of judicial harassment in Zimbabwe. The article will consider the multi-level sociological and contextual factors which influence the Government of Zimbabwe to have easy recourse to criminal law and the debilitating effect of these actions on HRDs. These factors include the breakdown of the rule of law resulting in state capture of the judiciary, the proven efficacy of judicial harassment from colonial times to date, and the lack of an adequate redress mechanism at international level. By mapping the use of the judiciary as a tool of repression, from the inception of modern day Zimbabwe to date, it is hoped that HRDs will realise that they are part of a greater community of activists throughout the ages and should emboldened in the realisation that it is an age old tactic used by fallen regimes which should not deter them from calling for accountability.

Keywords: autocratic regime, colonial legacy, judicial harassment, human rights defenders

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928 The Adaptive Role of Negative Emotions in Optimal Functioning

Authors: Brianne Nichols, John A. Parkinson

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Positive Psychology has provided a rich understanding of the beneficial effects of positive emotions in relation to optimal functioning, and research has been devoted to promote states of positive feeling and thinking. While this is a worthwhile pursuit, positive emotions are not useful in all contexts - some situations may require the individual to make use of their negative emotions to reach a desired end state. To account for the potential value of a wider range of emotional experiences that are common to the human condition, Positive Psychology needs to expand its horizons and investigate how individuals achieve positive outcomes using varied means. The current research seeks to understand the positive psychology of fear of failure (FF), which is a commonly experienced negative emotion relevant to most life domains. On the one hand, this emotion has been linked with avoidance motivation and self-handicap behaviours, on the other; FF has been shown to act as a drive to move the individual forward. To fully capture the depth of this highly subjective emotional experience and understand the circumstances under which FF may be adaptive, this study adopted a mixed methods design using SenseMaker; a web-based tool that combines the richness of narratives with the objectivity of numerical data. Two hundred participants consisting mostly of undergraduate university students shared a story of a time in the recent past when they feared failure of achieving a valued goal. To avoid researcher bias in the interpretation of narratives, participants self-signified their stories in a tagging system that was based on researchers’ aim to explore the role of past failures, the cognitive, emotional and behavioural profile of individuals high and low in FF, and the relationship between these factors. In addition, the role of perceived personal control and self-esteem were investigated in relation to FF using self-report questionnaires. Results from quantitative analyses indicated that individuals with high levels of FF, compared to low, were strongly influenced by past failures and preoccupied with their thoughts and emotions relating to the fear. This group also reported an unwillingness to accept their internal experiences, which in turn was associated with withdrawal from goal pursuit. Furthermore, self-esteem was found to mediate the relationship between perceived control and FF, suggesting that self-esteem, with or without control beliefs, may have the potential to buffer against high FF. It is hoped that the insights provided by the current study will inspire future research to explore the ways in which ‘acceptance’ may help individuals keep moving towards a goal despite the presence of FF, and whether cultivating a non-contingent self-esteem is the key to resilience in the face of failures.

Keywords: fear of failure, goal-pursuit, negative emotions, optimal functioning, resilience

Procedia PDF Downloads 186
927 Therapeutic Challenges in Treatment of Adults Bacterial Meningitis Cases

Authors: Sadie Namani, Lindita Ajazaj, Arjeta Zogaj, Vera Berisha, Bahrije Halili, Luljeta Hasani, Ajete Aliu

Abstract:

Background: The outcome of bacterial meningitis is strongly related to the resistance of bacterial pathogens to the initial antimicrobial therapy. The objective of the study was to analyze the initial antimicrobial therapy, the resistance of meningeal pathogens and the outcome of adults bacterial meningitis cases. Materials/methods: This prospective study enrolled 46 adults older than 16 years of age, treated for bacterial meningitis during the years 2009 and 2010 at the infectious diseases clinic in Prishtinë. Patients are categorized into specific age groups: > 16-26 years of age (10 patients), > 26-60 years of age (25 patients) and > 60 years of age (11 patients). All p-values < 0.05 were considered statistically significant. Data were analyzed using Stata 7.1 and SPSS 13. Results: During the two year study period 46 patients (28 males) were treated for bacterial meningitis. 33 patients (72%) had a confirmed bacterial etiology; 13 meningococci, 11 pneumococci, 7 gram-negative bacilli (Ps. aeruginosa 2, Proteus sp. 2, Acinetobacter sp. 2 and Klebsiella sp. 1 case) and 2 staphylococci isolates were found. Neurological complications developed in 17 patients (37%) and the overall mortality rate was 13% (6 deaths). Neurological complications observed were: cerebral abscess (7/46; 15.2%), cerebral edema (4/46; 8.7%); haemiparesis (3/46; 6.5%); recurrent seizures (2/46; 4.3%), and single cases of thrombosis sinus cavernosus, facial nerve palsy and decerebration (1/46; 2.1%). The most common meningeal pathogens were meningococcus in the youngest age group, gram negative-bacilli in second age group and pneumococcus in eldery age group. Initial single-agent antibiotic therapy (ceftriaxone) was used in 17 patients (37%): in 60% of patients in the youngest age group and in 44% of cases in the second age group. 29 patients (63%) were treated with initial dual-agent antibiotic therapy; ceftriaxone in combination with vancomycin or ampicillin. Ceftriaxone and ampicillin were the most commonly used antibiotics for the initial empirical therapy in adults > 50 years of age. All adults > 60 years of age were treated with the initial dual-agent antibiotic therapy as in this age group was recorded the highest mortality rate (M=27%) and adverse outcome (64%). Resistance of pathogens to antimicrobics was recorded in cases caused by gram-negative bacilli and was associated with greater risk for developing neurological complications (p=0.09). None of the gram-negative bacilli were resistant to carbapenems; all were resistant to ampicillin while 5/7 isolates were resistant to cefalosporins. Resistance of meningococci and pneumococci to beta-lactams was not recorded. There were no statistical differences in the occurrence of neurological complications (p > 0.05), resistance of meningeal pathogens to antimicrobics (p > 0.05) and the inital antimicrobial therapy (one vs. two antibiotics) concerning group-ages in adults. Conclusions: The initial antibiotic therapy with ceftriaxone alone or in combination with vancomycin or ampicillin did not cover cases caused by gram-negative bacilli.

Keywords: adults, bacterial meningitis, outcomes, therapy

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