Search results for: wildfire risk reduction
Commenced in January 2007
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Edition: International
Paper Count: 10512

Search results for: wildfire risk reduction

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

Authors: Rebecca Johnson, Elizabeth Hoban

Abstract:

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

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

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641 Development of a Framework for Family Therapy for Adolescent Substance Abuse: A Perspective from India

Authors: Tanya Anand, Arun Kandasamy, L. N. Suman

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Family based therapy for adolescent substance abuse has been studied to be effective in the West. Whereas, based on literature review, family therapy and interventions for adolescent substance abuse is still in its nascent stages in India. A multidimensional perspective to treatment has been indicated consistently in the Indian literature, but standardized therapy which addresses early substance abuse, from a social-ecological perspective has not been developed and studied for Indian population. While numerous researches have been conducted in India on the need of engaging the family in therapy for the purpose of symptom reduction, long-term maintenance of gains, and reducing family burnout, distress and dysfunction; a family based model in the Indian context has not been developed and tried, to the best of our knowledge. Hence, from the aim of building a model to treat adolescent substance abuse within the family context, experts in the area of mental health and deaddiction were interviewed to inform upon the clinical difficulties, challenges, uniqueness that Indian families present with. The integration of indigenous techniques that would be helpful in engaging families of young individuals with difficulties were also explored. Eight experts' who were interviewed, have 10-30 years of experience in working with families and substance users. An open-ended interview was conducted with the experts individually and audio-recorded. The interviews were then transcribed and subjected to qualitative analysis for building a framework and treatment guideline. Additionally, interviews with patients and their parents were conducted to elicit ‘felt needs’. The results of the analysis revealed culture-specific issues widely experienced within Indian families by adolescents and young adults, centering around the theme of Individuation versus collective identity and living. Substance abuse, in this framework, was found to be perceived as one of the maladaptive ways of the youth to disengage from the family and attempt at individuation and the responsibilities that are considered entitlements in the culture. On the other hand, interviews with family members revealed them to be engaging in inconsistent patterns of care and parenting. This was experienced and observed in terms of fostering interdependence within the family, sometimes within adverse socio-economic and societal conditions, where enacted and perceived stigma kept the individual and family members in a vicious loop of maladaptive coping patterns, dysfunctional family arrangements, and often leading to burnout with poor help seeking. The paper inform upon a framework that lays down the foundation for assessments, planning, case management and therapist competencies, required to address alcohol and drug issues in an Indian family context with such etiological factors at its heart. This paper will cover qualitative results of the interviews and present a model that may guide mental health professionals for treatment of adolescent substance use and family therapy.

Keywords: Indian families, family therapy, de-addiction, adolescent, youth, substance abuse, behavioral issues, felt needs, culture, etiology, model building, framework development, interviews

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640 Attachment Theory and Quality of Life: Grief Education and Training

Authors: Jane E. Hill

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Quality of life is an important component for many. With that in mind, everyone will experience some type of loss within his or her lifetime. A person can experience loss due to break up, separation, divorce, estrangement, or death. An individual may experience loss of a job, loss of capacity, or loss caused by human or natural-caused disasters. An individual’s response to such a loss is unique to them, and not everyone will seek services to assist them with their grief due to loss. Counseling can promote positive outcomes for clients that are grieving by addressing the client’s personal loss and helping the client process their grief. However, a lack of understanding on the part of counselors of how people grieve may result in negative client outcomes such as poor health, psychological distress, or an increased risk of depression. Education and training in grief counseling can improve counselors’ problem recognition and skills in treatment planning. The purpose of this study was to examine whether the Council for Accreditation of Counseling and Related Educational Programs (CACREP) master’s degree counseling students view themselves as having been adequately trained in grief theories and skills. Many people deal with grief issues that prevent them from having joy or purpose in their lives and that leaves them unable to engage in positive opportunities or relationships. This study examined CACREP-accredited master’s counseling students’ self-reported competency, training, and education in providing grief counseling. The implications for positive social change arising from the research may be to incorporate and promote education and training in grief theories and skills in a majority of counseling programs and to provide motivation to incorporate professional standards for grief training and practice in the mental health counseling field. The theoretical foundation used was modern grief theory based on John Bowlby’s work on Attachment Theory. The overall research question was how competent do master’s-level counselors view themselves regarding the education or training they received in grief theories or counseling skills in their CACREP-accredited studies. The author used a non-experimental, one shot survey comparative quantitative research design. Cicchetti’s Grief Counseling Competency Scale (GCCS) was administered to CACREP master’s-level counseling students enrolled in their practicum or internship experience, which resulted in 153 participants. Using a MANCOVA, there was significance found for relationships between coursework taken and (a) perceived assessment skills (p = .029), (b) perceived treatment skills (p = .025), and (c) perceived conceptual skills and knowledge (p = .003). Results of this study provided insight for CACREP master’s-level counseling programs to explore and discuss curriculum coursework inclusion of education and training in grief theories and skills.

Keywords: counselor education and training, grief education and training, grief and loss, quality of life

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639 Genetics of Pharmacokinetic Drug-Drug Interactions of Most Commonly Used Drug Combinations in the UK: Uncovering Unrecognised Associations

Authors: Mustafa Malki, Ewan R. Pearson

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Tools utilized by health care practitioners to flag potential adverse drug reactions secondary to drug-drug interactions ignore individual genetic variation, which has the potential to markedly alter the severity of these interactions. To our best knowledge, there have been limited published studies on the impact of genetic variation on drug-drug interactions. Therefore, our aim in this project is the discovery of previously unrecognized, clinically important drug-drug-gene interactions (DDGIs) within the list of most commonly used drug combinations in the UK. The UKBB database was utilized to identify the top most frequently prescribed drug combinations in the UK with at least one route of interaction (over than 200 combinations were identified). We have recognised 37 common and unique interacting genes considering all of our drug combinations. Out of around 600 potential genetic variants found in these 37 genes, 100 variants have met the selection criteria (common variant with minor allele frequency ≥ 5%, independence, and has passed HWE test). The association between these variants and the use of each of our top drug combinations has been tested with a case-control analysis under the log-additive model. As the data is cross-sectional, drug intolerance has been identified from the genotype distribution as presented by the lower percentage of patients carrying the risky allele and on the drug combination compared to those free of these risk factors and vice versa with drug tolerance. In GoDARTs database, the same list of common drug combinations identified by the UKBB was utilized here with the same list of candidate genetic variants but with the addition of 14 new SNPs so that we have a total of 114 variants which have met the selection criteria in GoDARTs. From the list of the top 200 drug combinations, we have selected 28 combinations where the two drugs in each combination are known to be used chronically. For each of our 28 combinations, three drug response phenotypes have been identified (drug stop/switch, dose decrease, or dose increase of any of the two drugs during their interaction). The association between each of the three phenotypes belonging to each of our 28 drug combinations has been tested against our 114 candidate genetic variants. The results show replication of four findings between both databases : (1) Omeprazole +Amitriptyline +rs2246709 (A > G) variant in CYP3A4 gene (p-values and ORs with the UKBB and GoDARTs respectively = 0.048,0.037,0.92,and 0.52 (dose increase phenotype)) (2) Simvastatin + Ranitidine + rs9332197 (T > C) variant in CYP2C9 gene (0.024,0.032,0.81, and 5.75 (drug stop/switch phenotype)) (3) Atorvastatin + Doxazosin + rs9282564 (T > C) variant in ABCB1 gene (0.0015,0.0095,1.58,and 3.14 (drug stop/switch phenotype)) (4) Simvastatin + Nifedipine + rs2257401 (C > G) variant in CYP3A7 gene (0.025,0.019,0.77,and 0.30 (drug stop/switch phenotype)). In addition, some other non-replicated, but interesting, significant findings were detected. Our work also provides a great source of information for researchers interested in DD, DG, or DDG interactions studies as it has highlighted the top common drug combinations in the UK with recognizing 114 significant genetic variants related to drugs' pharmacokinetic.

Keywords: adverse drug reactions, common drug combinations, drug-drug-gene interactions, pharmacogenomics

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638 Swedish Police Officers' Experiences of Meeting with Women Who Were Raped

Authors: Lisa Rudolfsson

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Socio-cognitive factors, such as social support and attribution of blame, influence the victim’s psychological adjustment after the abuse. Furthermore, the response from the person that the victim first confides to effect adjustment following the abuse. In Sweden, although police are investigating most of the reported cases of rape, very few rape-cases leads to trial and sentence. For many women who have been raped, contact with the police officer when reporting the crime will, therefore, be the most notable experience of how representatives for the Swedish society regard and handle what has happened. Hence, it seems urgent to gather information about these initial meetings. This study is part of a three-year research project, titled 'Female rape victims: Quality of initial police and medical care contact', funded by the Swedish Crime Victim and Support Authority. The focus of this study was on police officers in Sweden: their thoughts and experiences of meeting with raped women. Forthcoming are interviews with raped women about their experiences of meeting with police. Sixteen police officers participated in three focus groups and one interview. The participants consisted of five men and eleven women. Focus groups and interview were audio recorded and transcribed verbatim. The material was analyzed using thematic analysis. Participants described how violence against women was not a priority in Swedish society or within the Police Authority. They talked about rape cases as a Sisyphean work-task that put high demands on them, while they also lacked training and support. They expressed a wish to offer the woman some kind of restoration, and they talked about their work as potentially making a difference for the woman – even if she did not get juridical justice. However, participants also described that they did not feel validated in their hard work. They talked about working rape cases as causing them a great deal of frustration - directed towards the Police Authority, the juridical system, colleagues, and sometimes towards the woman. Participants also described how meeting with raped women was a work that affected them in a personal manner. Listening to stories about sexual violence made the participants sad, and they described it as a struggle to understand. They described wondering how the woman’s life turned out and how they sometimes questioned if they had done enough. Some of the conclusions concern the lack of prerequisites needed for police officers to be able to offer a good-enough treatment of raped women, as well as the lack of tools needed for police officers to care for themselves. In lack of training, validation, and support, the knowledge of how to offer a good- enough treatment of raped women becomes a task learned by doing. Attempts to offer, if not legal justice, then at least some kind of restoration becomes a personal task, dependent on individual police officers. It seems urgent that we address the risk of police officers’ frustration building up to be detrimental for both the crime victim and the officer her/himself.

Keywords: focus groups, police, raped women, restoration

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637 Superparamagnetic Core Shell Catalysts for the Environmental Production of Fuels from Renewable Lignin

Authors: Cristina Opris, Bogdan Cojocaru, Madalina Tudorache, Simona M. Coman, Vasile I. Parvulescu, Camelia Bala, Bahir Duraki, Jeroen A. Van Bokhoven

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The tremendous achievements in the development of the society concretized by more sophisticated materials and systems are merely based on non-renewable resources. Consequently, after more than two centuries of intensive development, among others, we are faced with the decrease of the fossil fuel reserves, an increased impact of the greenhouse gases on the environment, and economic effects caused by the fluctuations in oil and mineral resource prices. The use of biomass may solve part of these problems, and recent analyses demonstrated that from the perspective of the reduction of the emissions of carbon dioxide, its valorization may bring important advantages conditioned by the usage of genetic modified fast growing trees or wastes, as primary sources. In this context, the abundance and complex structure of lignin may offer various possibilities of exploitation. However, its transformation in fuels or chemicals supposes a complex chemistry involving the cleavage of C-O and C-C bonds and altering of the functional groups. Chemistry offered various solutions in this sense. However, despite the intense work, there are still many drawbacks limiting the industrial application. Thus, the proposed technologies considered mainly homogeneous catalysts meaning expensive noble metals based systems that are hard to be recovered at the end of the reaction. Also, the reactions were carried out in organic solvents that are not acceptable today from the environmental point of view. To avoid these problems, the concept of this work was to investigate the synthesis of superparamagnetic core shell catalysts for the fragmentation of lignin directly in the aqueous phase. The magnetic nanoparticles were covered with a nanoshell of an oxide (niobia) with a double role: to protect the magnetic nanoparticles and to generate a proper (acidic) catalytic function and, on this composite, cobalt nanoparticles were deposed in order to catalyze the C-C bond splitting. With this purpose, we developed a protocol to prepare multifunctional and magnetic separable nano-composite Co@Nb2O5@Fe3O4 catalysts. We have also established an analytic protocol for the identification and quantification of the fragments resulted from lignin depolymerization in both liquid and solid phase. The fragmentation of various lignins occurred on the prepared materials in high yields and with very good selectivity in the desired fragments. The optimization of the catalyst composition indicated a cobalt loading of 4wt% as optimal. Working at 180 oC and 10 atm H2 this catalyst allowed a conversion of lignin up to 60% leading to a mixture containing over 96% in C20-C28 and C29-C37 fragments that were then completely fragmented to C12-C16 in a second stage. The investigated catalysts were completely recyclable, and no leaching of the elements included in the composition was determined by inductively coupled plasma optical emission spectrometry (ICP-OES).

Keywords: superparamagnetic core-shell catalysts, environmental production of fuels, renewable lignin, recyclable catalysts

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636 Competitive Effects of Differential Voting Rights and Promoter Control in Indian Start-Ups

Authors: Prateek Bhattacharya

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The definition of 'control' in India is a rapidly evolving concept, owing to varying rights attached to varying securities. Shares with differential voting rights (DVRs) provide the holder with differential rights as to voting, as compared to ordinary equity shareholders of the company. Such DVRs can amount to both superior voting rights and inferior voting rights, where DVRs with superior voting rights amount to providing the holder with golden shares in the company. While DVRs are not a novel concept in India having been recognized since 2000, they were placed on a back burner by the Securities and Exchange Board of India (SEBI) in 2010 after issuance of DVRs with superior voting rights was restricted. In June 2019, the SEBI rekindled the ebbing fire of DVRs, keeping mind the fast-paced nature of the global economy, the government's faith that India’s ‘new age technology companies’ (i.e., Start-Ups) will lead the charge in achieving its goal of India becoming a $5 trillion dollar economy by 2024, and recognizing that the promoters of such Start-Ups seek to raise capital without losing control over their companies. DVRs with superior voting rights guarantee promoters with up to 74% shareholding in Start-Ups for a period of 5 years, meaning that the holder of such DVRs can exercise sole control and material influence over the company for that period. This manner of control has the potential of causing both pro-competitive and anti-competitive effects in the markets where these companies operate. On the one hand, DVRs will allow Start-Up promoters/founders to retain control of their companies and protect its business interests from foreign elements such as private/public investors – in a scenario where such investors have multiple investments in firms engaged in associated lines of business (whether on a horizontal or vertical level) and would seek to influence these firms to enter into potential anti-competitive arrangements with one another, DVRs will enable the promoters to thwart such scenarios. On the other hand, promoters/founders who themselves have multiple investments in Start-Ups, which are in associated lines of business run the risk of influencing these associated Start-Ups to engage in potentially anti-competitive arrangements in the name of profit maximisation. This paper shall be divided into three parts: Part I shall deal with the concept of ‘control’, as deliberated upon and decided by the SEBI and the Competition Commission of India (CCI) under both company/securities law and competition law; Part II shall review this definition of ‘control’ through the lens of DVRs, and Part III shall discuss the aforementioned potential pro-competitive and anti-competitive effects caused by the DVRs by examining the current Indian Start-Up scenario. The paper shall conclude by providing suggestions for the CCI to incorporate a clearer and more progressive concept of ‘control’.

Keywords: competition law, competitive effects, control, differential voting rights, DVRs, investor shareholding, merger control, start-ups

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635 Carbon-Foam Supported Electrocatalysts for Polymer Electrolyte Membrane Fuel Cells

Authors: Albert Mufundirwa, Satoru Yoshioka, K. Ogi, Takeharu Sugiyama, George F. Harrington, Bretislav Smid, Benjamin Cunning, Kazunari Sasaki, Akari Hayashi, Stephen M. Lyth

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Polymer electrolyte membrane fuel cells (PEMFCs) are electrochemical energy conversion devices used for portable, residential and vehicular applications due to their low emissions, high efficiency, and quick start-up characteristics. However, PEMFCs generally use expensive, Pt-based electrocatalysts as electrode catalysts. Due to the high cost and limited availability of platinum, research and development to either drastically reduce platinum loading, or replace platinum with alternative catalysts is of paramount importance. A combination of high surface area supports and nano-structured active sites is essential for effective operation of catalysts. We synthesize carbon foam supports by thermal decomposition of sodium ethoxide, using a template-free, gram scale, cheap, and scalable pyrolysis method. This carbon foam has a high surface area, highly porous, three-dimensional framework which is ideal for electrochemical applications. These carbon foams can have surface area larger than 2500 m²/g, and electron microscopy reveals that they have micron-scale cells, separated by few-layer graphene-like carbon walls. We applied this carbon foam as a platinum catalyst support, resulting in the improved electrochemical surface area and mass activity for the oxygen reduction reaction (ORR), compared to carbon black. Similarly, silver-decorated carbon foams showed higher activity and efficiency for electrochemical carbon dioxide conversion than silver-decorated carbon black. A promising alternative to Pt-catalysts for the ORR is iron-impregnated nitrogen-doped carbon catalysts (Fe-N-C). Doping carbon with nitrogen alters the chemical structure and modulates the electronic properties, allowing a degree of control over the catalytic properties. We have adapted our synthesis method to produce nitrogen-doped carbon foams with large surface area, using triethanolamine as a nitrogen feedstock, in a novel bottom-up protocol. These foams are then infiltrated with iron acetate (FeAc) and pyrolysed to form Fe-N-C foams. The resulting Fe-N-C foam catalysts have high initial activity (half-wave potential of 0.68 VRHE), comparable to that of commercially available Pt-free catalysts (e.g., NPC-2000, Pajarito Powder) in acid solution. In alkaline solution, the Fe-N-C carbon foam catalysts have a half-wave potential of 0.89 VRHE, which is higher than that of NPC-2000 by almost 10 mVRHE, and far out-performing platinum. However, the durability is still a problem at present. The lessons learned from X-ray absorption spectroscopy (XAS), transmission electron microscopy (TEM), X-ray photoelectron spectroscopy (XPS), and electrochemical measurements will be used to carefully design Fe-N-C catalysts for higher performance PEMFCs.

Keywords: carbon-foam, polymer electrolyte membrane fuel cells, platinum, Pt-free, Fe-N-C, ORR

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634 Development of Mesoporous Gel Based Nonwoven Structure for Thermal Barrier Application

Authors: R. P. Naik, A. K. Rakshit

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In recent years, with the rapid development in science and technology, people have increasing requirements on uses of clothing for new functions, which contributes to opportunities for further development and incorporation of new technologies along with novel materials. In this context, textiles are of fast decalescence or fast heat radiation media as per as comfort accountability of textile articles are concern. The microstructure and texture of textiles play a vital role in determining the heat-moisture comfort level of the human body because clothing serves as a barrier to the outside environment and a transporter of heat and moisture from the body to the surrounding environment to keep thermal balance between body heat produced and body heat loss. The main bottleneck which is associated with textile materials to be successful as thermal insulation materials can be enumerated as; firstly, high loft or bulkiness of material so as to provide predetermined amount of insulation by ensuring sufficient trapping of air. Secondly, the insulation depends on forced convection; such convective heat loss cannot be prevented by textile material. Third is that the textile alone cannot reach the level of thermal conductivity lower than 0.025 W/ m.k of air. Perhaps, nano-fibers can do so, but still, mass production and cost-effectiveness is a problem. Finally, such high loft materials for thermal insulation becomes heavier and uneasy to manage especially when required to carry over a body. The proposed works aim at developing lightweight effective thermal insulation textiles in combination with nanoporous silica-gel which provides the fundamental basis for the optimization of material properties to achieve good performance of the clothing system. This flexible nonwoven silica-gel composites fabric in intact monolith was successfully developed by reinforcing SiO2-gel in thermal bonded nonwoven fabric via sol-gel processing. Ambient Pressure Drying method is opted for silica gel preparation for cost-effective manufacturing. The formed structure of the nonwoven / SiO₂ -gel composites were analyzed, and the transfer properties were measured. The effects of structure and fibre on the thermal properties of the SiO₂-gel composites were evaluated. Samples are then tested against untreated samples of same GSM in order to study the effect of SiO₂-gel application on various properties of nonwoven fabric. The nonwoven fabric composites reinforced with aerogel showed intact monolith structure were also analyzed for their surface structure, functional group present, microscopic images. Developed product reveals a significant reduction in pores' size and air permeability than the conventional nonwoven fabric. Composite made from polyester fibre with lower GSM shows lowest thermal conductivity. Results obtained were statistically analyzed by using STATISTICA-6 software for their level of significance. Univariate tests of significance for various parameters are practiced which gives the P value for analyzing significance level along with that regression summary for dependent variable are also studied to obtain correlation coefficient.

Keywords: silica-gel, heat insulation, nonwoven fabric, thermal barrier clothing

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633 Awake Fiberoptic Intubation for Airway Management in a Patient with an Ulceroproliferative Mass of the Aryepiglottic Fold Obscuring Glottic Opening

Authors: Dielle Martins

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A 45-year-old female, Manju Devi, presented with a 6-month history of progressively changing voice, difficulty breathing for the past month, and worsening dysphagia for the past two weeks, particularly with solids. Direct laryngoscopy revealed an ulceroproliferative mass arising from the left aryepiglottic fold, obscuring the glottic opening. Imaging with contrast-enhanced CT of the neck showed a lobulated, heterogeneous mass in the hypo-pharyngeal region, encroaching into the airway and involving the aryepiglottic fold and pyriform sinus, raising concerns for a malignant lesion. Small reactive lymph nodes were identified in the left submandibular region and along the carotid sheath. Due to the location of the mass near the glottis and the risk of complete airway obstruction, securing the airway was a critical concern. An awake fiberoptic bronchoscopy for endotracheal intubation was chosen as the safest approach. The patient was prepped with local anesthesia to the airway using nebulized 10% lignocaine and 4% lignocaine spray to the oral mucosa. After obtaining informed consent, the patient was positioned supine on the operating table. To facilitate the fiberoptic intubation, the patient’s neck was extended, and the head was laterally rotated 30 degrees to the left. This positioning helped optimize the visualization of the glottic opening, which was obscured by the mass. The fiberoptic scope was carefully passed through the oral cavity, past the uvula, and into the laryngeal area. As the scope advanced, the ulceroproliferative mass was observed covering most of the glottis, with only the anterior commissure visible. After further gentle manipulation, including the use of a shoulder roll for additional neck extension and rotation, a clearer view of the anterior two-thirds of the glottis was achieved. A 6.5mm internal diameter endotracheal tube was advanced over the fiberoptic scope and successfully positioned just above the carina. General anesthesia was then induced, and an excision biopsy of the growth was performed. This case underscores the importance of careful preoperative airway evaluation and the role of awake fiberoptic intubation in managing complex airway obstructions. Proper patient positioning, including neck extension and lateral rotation, proved crucial for successful intubation in the presence of a mass obstructing the glottic opening. This case emphasizes the techniques used in the fiberoptic intubation and the careful positioning of the patient, which were critical for the success of the procedure.

Keywords: awake fiberoptic bronchoscopy in laryngeal growth, Difficult intubation in glottic cancer, glottic cancer, difficult airway

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632 Implementing a Prevention Network for the Ortenaukreis

Authors: Klaus Froehlich-Gildhoff, Ullrich Boettinger, Katharina Rauh, Angela Schickler

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The Prevention Network Ortenaukreis, PNO, funded by the German Ministry of Education and Research, aims to promote physical and mental health as well as the social inclusion of 3 to 10 years old children and their families in the Ortenau district. Within a period of four years starting 11/2014 a community network will be established. One regional and five local prevention representatives are building networks with stakeholders of the prevention and health promotion field bridging the health care, educational and youth welfare system in a multidisciplinary approach. The regional prevention representative implements regularly convening prevention and health conferences. On a local level, the 5 local prevention representatives implement round tables in each area as a platform for networking. In the setting approach, educational institutions are playing a vital role when gaining access to children and their families. Thus the project will offer 18 month long organizational development processes with specially trained coaches to 25 kindergarten and 25 primary schools. The process is based on a curriculum of prevention and health promotion which is adapted to the specific needs of the institutions. Also to ensure that the entire region is reached demand oriented advanced education courses are implemented at participating day care centers, kindergartens and schools. Evaluation method: The project is accompanied by an extensive research design to evaluate the outcomes of different project components such as interview data from community prevention agents, interviews and network analysis with families at risk on their support structures, data on community network development and monitoring, as well as data from kindergarten and primary schools. The latter features a waiting-list control group evaluation in kindergarten and primary schools with a mixed methods design using questionnaires and interviews with pedagogues, teachers, parents, and children. Results: By the time of the conference pre and post test data from the kindergarten samples (treatment and control group) will be presented, as well as data from the first project phase, such as qualitative interviews with the prevention coordinators as well as mixed methods data from the community needs assessment. In supporting this project, the Federal Ministry aims to gain insight into efficient components of community prevention and health promotion networks as it is implemented and evaluated. The district will serve as a model region, so that successful components can be transferred to other regions throughout Germany. Accordingly, the transferability to other regions is of high interest in this project.

Keywords: childhood research, health promotion, physical health, prevention network, psychological well-being, social inclusion

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631 Effect of Maternal Factors and C-Peptide and Insulin Levels in Cord Blood on the Birth Weight of Newborns: A Preliminary Study from Southern Sri Lanka

Authors: M. H. A. D. de Silva, R. P. Hewawasam, M. A. G. Iresha

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Macrosomia is common in infants born to not only women diagnosed with gestational diabetes mellitus but also non-diabetic obese women. Maternal Body Mass Index (BMI) correlates with the incidence of large for gestational age infants. Obesity has reached epidemic levels in modern societies. During the past two decades, obesity in children and adolescents has risen significantly in Asian populations including Sri Lanka. There is increasing evidence to believe that infants who are born large for gestational age are more likely to be obese in childhood and adolescence and are at risk of cardiovascular and metabolic complications later in life. It is also established that Asians have lower skeletal muscle mass, low bone mineral content and excess body fat for a given BMI indicating a genetic predisposition in the occurrence of obesity. The objective of this study is to determine the effect of maternal weight, weight gain during pregnancy, c-peptide and insulin concentrations in the cord blood on the birth of appropriate for and large for gestational age infants in a tertiary care center in Southern Sri Lanka. Umbilical cord blood was collected from 90 newborns (Male 40, Female 50; gestational age 35-42 weeks) after double clamping the umbilical cord before separation of the placenta and the concentration of insulin and C-peptide were measured by ELISA technique. Anthropometric parameters of the newborn such as birth weight, length, ponderal index, occipital frontal, chest, hip and calf circumferences were measured, and characteristics of the mother were collected. The relationship between insulin, C-peptide and anthropometrics were assessed by Spearman correlation. The multiple logistic regression analysis examined influences of maternal weight, weight gain during pregnancy, C-peptide and insulin concentrations in cord blood as covariates on the birth of large for gestational age infants. A significant difference (P<0.001) was observed between the insulin levels of infants born large for gestational age (18.73 ± 0.52 µlU/ml) and appropriate for gestational age (13.08 ± 0.56 µlU/ml). Consistently, A significant decrease in concentration (41.68%, P<0.001) was observed between C-peptide levels of infants born large for gestational age and appropriate for gestational age. Cord blood insulin and C-peptide levels had a significant correlation with birth weight (r=0.35, P<0.05) of the newborn at delivery. Maternal weight and BMI which are indicators of maternal nutrition were proven to be directly correlated with birth weight and length. To our knowledge, this relationship was investigated for the first time in a Sri Lankan setting and was also evident in our results. This study confirmed the fact that insulin and C-peptide play a major role in regulating fetal growth. According to the results obtained in this study, we can suggest that the increased BMI of the mother has a direct influence on increased maternal insulin secretion, which may subsequently affect cord insulin and C-peptide levels and also birth weight of the infant.

Keywords: C-peptide, insulin, large for gestational age, maternal weight

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630 Corrosion Protective Coatings in Machines Design

Authors: Cristina Diaz, Lucia Perez, Simone Visigalli, Giuseppe Di Florio, Gonzalo Fuentes, Roberto Canziani, Paolo Gronchi

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During the last 50 years, the selection of materials is one of the main decisions in machine design for different industrial applications. It is due to numerous physical, chemical, mechanical and technological factors to consider in it. Corrosion effects are related with all of these factors and impact in the life cycle, machine incidences and the costs for the life of the machine. Corrosion affects the deterioration or destruction of metals due to the reaction with the environment, generally wet. In food industry, dewatering industry, concrete industry, paper industry, etc. corrosion is an unsolved problem and it might introduce some alterations of some characteristics in the final product. Nowadays, depending on the selected metal, its surface and its environment of work, corrosion prevention might be a change of metal, use a coating, cathodic protection, use of corrosion inhibitors, etc. In the vast majority of the situations, use of a corrosion resistant material or in its defect, a corrosion protection coating is the solution. Stainless steels are widely used in machine design, because of their strength, easily cleaned capacity, corrosion resistance and appearance. Typical used are AISI 304 and AISI 316. However, their benefits don’t fit every application, and some coatings are required against corrosion such as some paintings, galvanizing, chrome plating, SiO₂, TiO₂ or ZrO₂ coatings, etc. In this work, some coatings based in a bilayer made of Titanium-Tantalum, Titanium-Niobium, Titanium-Hafnium or Titanium-Zirconium, have been developed used magnetron sputtering configuration by PVD (Physical Vapor Deposition) technology, for trying to reduce corrosion effects on AISI 304, AISI 316 and comparing it with Titanium alloy substrates. Ti alloy display exceptional corrosion resistance to chlorides, sour and oxidising acidic media and seawater. In this study, Ti alloy (99%) has been included for comparison with coated AISI 304 and AISI 316 stainless steel. Corrosion tests were conducted by a Gamry Instrument under ASTM G5-94 standard, using different electrolytes such as tomato salsa, wine, olive oil, wet compost, a mix of sand and concrete with water and NaCl for testing corrosion in different industrial environments. In general, in all tested environments, the results showed an improvement of corrosion resistance of all coated AISI 304 and AISI 316 stainless steel substrates when they were compared to uncoated stainless steel substrates. After that, comparing these results with corrosion studies on uncoated Ti alloy substrate, it was observed that in some cases, coated stainless steel substrates, reached similar current density that uncoated Ti alloy. Moreover, Titanium-Zirconium and Titanium-Tantalum coatings showed for all substrates in study including coated Ti alloy substrates, a reduction in current density more than two order in magnitude. As conclusion, Ti-Ta, Ti-Zr, Ti-Nb and Ti-Hf coatings have been developed for improving corrosion resistance of AISI 304 and AISI 316 materials. After corrosion tests in several industry environments, substrates have shown improvements on corrosion resistance. Similar processes have been carried out in Ti alloy (99%) substrates. Coated AISI 304 and AISI 316 stainless steel, might reach similar corrosion protection on the surface than uncoated Ti alloy (99%). Moreover, coated Ti Alloy (99%) might increase its corrosion resistance using these coatings.

Keywords: coatings, corrosion, PVD, stainless steel

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629 Water Infrastructure Asset Management: A Comparative Analysis of Three Urban Water Utilities in South Africa

Authors: Elkington S. Mnguni

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Water and sanitation services in South Africa are characterized by both achievements and challenges. After the end of apartheid in 1994 the newly elected government faced the challenge of eradicating backlogs with respect to access to basic services, including water and sanitation. Capital investment made in the development of new water and sanitation infrastructure to provide basic services to previously disadvantaged communities has grown, to a certain extent, at the expense of investment in the operation and maintenance of new and existing infrastructure. Challenges resulting from aging infrastructure and poor plant performance highlight the need for investing in the maintenance, rehabilitation, and replacement of existing infrastructure to optimize the return on investment. Advanced water infrastructure asset management (IAM) is key to achieving adequate levels of service, particularly with regard to reliable and high quality drinking water supply, prevention of urban flooding, efficient use of natural resources and prevention of pollution and associated risks. Against this backdrop, this paper presents an appraisal of water and sanitation IAM systems in South Africa’s three utilities, being metropolitan cities in the Gauteng Province. About a quarter of the national population lives in the three rapidly urbanizing cities of Johannesburg, Ekurhuleni and Tshwane, located in a semi-arid region. A literature review has been done and field visits to some of the utility facilities are being conducted. Semi-structured interviews will be conducted with the three utilities. The following critical factors are being analysed in terms of compliance with the national Water Services IAM Strategy (2011) and other applicable legislation: asset registers; capacity of assets; current and predicted demand; funding availability / budget allocations; plans: operation & maintenance, renewal & replacement, and risk management; no-drop status (non-revenue water levels); blue drop status (water quality); green drop status (effluent quality); and skills availability. Some of the key challenges identified in the literature review include: funding constraints, Skills shortage, and wastewater treatment plants operating beyond their design capacities. These challenges will be verified during field visits and research interviews. Gaps between literature and practice will be identified and relevant recommendations made if necessary. The objective of this study is to contribute to the resolution of the challenges brought about by the backlogs in the operation and maintenance of water and sanitation assets in the country in general, and in the three cities in particular, thus improving the sustainability thereof.

Keywords: asset management, backlogs, levels of service, sustainability, water and sanitation infrastructure

Procedia PDF Downloads 231
628 Metaphors, Cognition, and Action: Conceptual Metaphor Analysis of President Akuffo-Addo’s Speeches in the COVID-19 Crisis

Authors: Isaac Kwabena Adubofour, Esther Serwaah Afreh

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Political speeches are structured in ways that ensure that the ideology of the leader is communicated in ways that the opinions of the audience are influenced towards certain lines of action, and in crisis situations like the outbreak of a global pandemic, public opinion and action are influenced through speeches. The foregoing explains the presence of metaphors in presidential speeches. Crises require, among other things, that the thoughts, emotions, and actions of the population are controlled in dealing with the problems at hand. The primary question this study assesses is how the use of metaphors in crisis situations, like the COVID-19 pandemic, influences thought, determines the policies a government adopts, and influences the reactions of the people. The study focused on twenty-four (24) addresses of the President of Ghana, Nana Addo Danquah Akuffo-Addo, on the COVID-19 pandemic and his government’s efforts to manage the crisis. The nature and relevance of presidential speeches and the presence of metaphors in such speeches have been investigated. However, there is a paucity of research on the connection between the presence of metaphors in presidential speeches and their influence on thought and action. Especially within the crisis of the COVID-19 pandemic, it is pertinent to investigate how the presence of metaphors in presidential addresses influences social thought and action. Thus, the current study sought to investigate the potential for metaphor use to influence thought and action on a national scale during the COVID crisis. The speeches were collected from the website of the presidency. The analysis was done using Metaphor Identification Process by the Praglejazz Group (2007) with conceptual metaphor theory (Lakoff & Johnson, 1980) as the theoretical foundation. The findings of the study show that the President’s adoption of war metaphors may not have been ideal since it triggered thoughts, policies, and social actions in line with war. For instance, the reference to health workers as heroes, heroines, and frontline workers praised the efforts of these workers over the efforts of the rest of the population, and that may have contributed to the apathy that arose among the citizens in dealing with the pandemic. This prioritization of the frontline workers explains why their taxes were forgiven for a considerable period. The government further absorbed utility bills of citizens during the pandemic. All these financial commitments may not have been advisable for a developing country like Ghana, but the authors argue that the actions may have been influenced by the metaphor that was adopted. Another finding that is explored is the problem of stigmatization in the country during the pandemic and its connection with the war metaphor. This investigation expands the research on metaphors, social thought and action, and crisis communication. Its contribution to metaphor use, thought, and action suggest its potential implication for education and other fields.

Keywords: conceptual metaphor theory, COVID-19, crisis communication, presidential addresses, risk communication

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627 Ultrasonic Atomizer for Turbojet Engines

Authors: Aman Johri, Sidhant Sood, Pooja Suresh

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This paper suggests a new and more efficient method of atomization of fuel in a combustor nozzle of a high bypass turbofan engine, using ultrasonic vibrations. Since atomization of fuel just before the fuel spray is injected into the combustion chamber is an important and crucial aspect related to functioning of a propulsion system, the technology suggested by this paper and the experimental analysis on the system components eventually proves to assist in complete and rapid combustion of the fuel in the combustor module of the engine. Current propulsion systems use carburetors, atomization nozzles and apertures in air intake pipes for atomization. The idea of this paper is to deploy new age hybrid technology, namely the Ultrasound Field Effect (UFE) to effectively atomize fuel before it enters the combustion chamber, as a viable and effective method to increase efficiency and improve upon existing designs. The Ultrasound Field Effect is applied axially, on diametrically opposite ends of an atomizer tube that gloves onto the combustor nozzle, where the fuel enters and exits under a pre-defined pressure. The Ultrasound energy vibrates the fuel particles to a breakup frequency. At reaching this frequency, the fuel particles start disintegrating into smaller diameter particles perpendicular to the axis of application of the field from the parent boundary layer of fuel flow over the baseplate. These broken up fuel droplets then undergo swirling effect as per the original nozzle design, with a higher breakup ratio than before. A significant reduction of the size of fuel particles eventually results in an increment in the propulsive efficiency of the engine. Moreover, the Ultrasound atomizer operates within a control frequency such that effects of overheating and induced vibrations are least felt on the overall performance of the engine. The design of an electrical manifold for the multiple-nozzle system over a typical can-annular combustor is developed along with this study, such that the product can be installed and removed easily for maintenance and repairing, can allow for easy access for inspections and transmits least amount of vibrational energy to the surface of the combustor. Since near-field ultrasound is used, the vibrations are easily controlled, thereby successfully reducing vibrations on the outer shell of the combustor. Experimental analysis is carried out on the effect of ultrasonic vibrations on flowing jet turbine fuel using an ultrasound generator probe and results of an effective decrease in droplet size across a constant diameter, away from the boundary layer of flow is noted using visual aid by observing under ultraviolet light. The choice of material for the Ultrasound inducer tube and crystal along with the operating range of temperatures, pressures, and frequencies of the Ultrasound field effect are also studied in this paper, while taking into account the losses incurred due to constant vibrations and thermal loads on the tube surface.

Keywords: atomization, ultrasound field effect, titanium mesh, breakup frequency, parent boundary layer, baseplate, propulsive efficiency, jet turbine fuel, induced vibrations

Procedia PDF Downloads 242
626 Active Abdominal Compression Device for Treatment of Orthostatic Hypotension

Authors: Vishnu Emani, Andreas Escher, Ellen Roche

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Background: Orthostatic hypotension (OH) is an autonomic disorder marked by a sudden drop in blood pressure upon standing resulting from autonomic dysfunction. OH is especially prevalent in elderly populations, affecting more than 30% of Americans over the age of 70. OH is one of the most significant risk factors for accidental falls in elderly populations, making it a crucial focus for medical and device therapies. Pharmacologic therapy with midodrine and fludrocortisone may alleviate hypotension but have significant adverse side effects. Abdominal passive compression devices (binders) are more effective than lower extremity compression stockings at mitigating postural hypotension, by improving venous return to the heart. However, abdominal binders are difficult to don and uncomfortable to wear, leading to poor compliance. A disadvantage of passive compression devices is their inability to selectively compress during the crucial moment of standing. We have recently developed an active compression device that applies external pressure on the abdomen during the transition from a prone to a supine position and conducted initial prototype testing. Methods: An active abdominal compression device was developed utilizing a simple, servo-driven straptightening mechanism to supply tension onto foam fabric, which applies pressure to the abdomen. Healthy volunteers (n=5) were utilized for prototype testing and were subjected to three conditions: no compression, passive compression (i.e. standard abdominal binder), and active compression (device prototype). Abdominal applied pressure during device activation was measured by a strain-gauge manometer placed between the skin and binder. Systolic (SBP) and mean (MAP) arterial blood pressure was measured by standard blood pressure cuff in supine position followed by repeat measurements at 1 minute intervals for 5 minutes following upright position. A survey tool was administered to determine scores (1-10) for comfort and ease of donning abdominal binders. Results: Abdominal pressure increased from 0 to 15±3 mmHg upon device activation for both passive and active compression devices. During the transition from supine to an upright position, both active and passive compression devices demonstrated significantly higher MAP compared to the no-compression condition (67±4, 68±5, 62±5 respectively, P<0.05), but there was no statistically significant difference in SBP or MAP when comparing active to passive compression. Active compression demonstrated significantly higher comfort scores (8.3±1) compared to passive compression (3.2±2) but lower when compared to no compression (10). Subjects universally reported that active compression device was easier to don compared to passive device. Conclusions: Active or passive abdominal compression prevents hypotension associated with postural changes. Active compression is associated with increased comfort and ease of donning compared to passive compression devices. Future trials are warranted to investigate the efficacy of our device in patients with OH.

Keywords: orthostatic hypotension, compression binder, abdominal binder, active abdominal compression

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625 Improved Operating Strategies for the Optimization of Proton Exchange Membrane Fuel Cell System Performance

Authors: Guillaume Soubeyran, Fabrice Micoud, Benoit Morin, Jean-Philippe Poirot-Crouvezier, Magali Reytier

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Proton Exchange Membrane Fuel Cell (PEMFC) technology is considered as a solution for the reduction of CO2 emissions. However, this technology still meets several challenges for high-scale industrialization. In this context, the increase of durability remains a critical aspect for competitiveness of this technology. Fortunately, performance degradations in nominal operating conditions is partially reversible, meaning that if specific conditions are applied, a partial recovery of fuel cell performance can be achieved, while irreversible degradations can only be mitigated. Thus, it is worth studying the optimal conditions to rejuvenate these reversible degradations and assessing the long-term impact of such procedures on the performance of the cell. Reversible degradations consist mainly of anode Pt active sites poisoning by carbon monoxide at the anode, heterogeneities in water management during use, and oxidation/deactivation of Pt active sites at the cathode. The latter is identified as a major source of reversible performance loss caused by the presence oxygen, high temperature and high cathode potential that favor platinum oxidation, especially in high efficiency operating points. Hence, we studied here a recovery procedure aiming at reducing the platinum oxides by decreasing cathode potential during operation. Indeed, the application of short air starvation phase leads to a drop of cathode potential. Cell performances are temporarily increased afterwards. Nevertheless, local temperature and current heterogeneities within the cells are favored and shall be minimized. The consumption of fuel during the recovery phase shall also be considered to evaluate the global efficiency. Consequently, the purpose of this work is to find an optimal compromise between the recovery of reversible degradations by air starvation, the increase of global cell efficiency and the mitigation of irreversible degradations effects. Different operating parameters have first been studied such as cell voltage, temperature and humidity in single cell set-up. Considering the global PEMFC system efficiency, tests showed that reducing duration of recovery phase and reducing cell voltage was the key to ensure an efficient recovery. Recovery phase frequency was a major factor as well. A specific method was established to find the optimal frequency depending on the duration and voltage of the recovery phase. Then, long-term degradations have also been studied by applying FC-DLC cycles based on NEDC cycles on a 4-cell short stack by alternating test sequences with and without recovery phases. Depending on recovery phase timing, cell efficiency during the cycle was increased up to 2% thanks to a mean voltage increase of 10 mV during test sequences with recovery phases. However, cyclic voltammetry tests results suggest that the implementation of recovery phases causes an acceleration of the decrease of platinum active areas that could be due to the high potential variations applied to the cathode electrode during operation.

Keywords: durability, PEMFC, recovery procedure, reversible degradation

Procedia PDF Downloads 138
624 Impact of an Educational Intervention on Knowledge, Attitude and Practices of Community Members on Schistosomiasis in Nelson Mandela Bay

Authors: Prince S. Campbell, Janine B. Adams, Melusi Thwala, Opeoluwa Oyedele, Paula E. Melariri

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Schistosomiasis, often known as bilharzia, is a parasitic water-borne disease caused by trematode flatworms of the genus Schistosoma. Schistosomiasis infection and prevention have been found to be influenced by a range of socio-cultural risk factors, including human characteristics (e.g., gender, age, education, knowledge, attitude, and practices), as well as environmental and economic elements. Lack of awareness of the disease may also contribute to an individual's tendency to participate in behaviours or activities that heighten their susceptibility to infection. The current study assessed the community knowledge, attitude and practices (KAP) on schistosomiasis and implemented an educational intervention following pre-test interviews. A cross-sectional quasi-experimental research design was used in this quantitative study. Pre- and post-intervention interview format surveys were conducted using a structured questionnaire, targeting individuals aged 18–65 years residing within 5 km of select water bodies. The questionnaire contained 54 close-ended questions about schistosomiasis causes, transmission, and clinical symptoms and the participants were interviewed face-to-face in their homes. Data was captured on Question Pro and analyzed using Microsoft Office Excel 365 (2019) and R (version 4.3.1) software. Overall, 380 individuals completed the pre and post-intervention assessments; 194 and 185 were males (51.1%) and females (48.7%), respectively. A notable 91.3% of participants did not know about schistosomiasis in the pre-intervention phase; however, the mean post-intervention test score (9.4 ± 1.4) for knowledge among participants was higher than the pre-intervention test score (2.2 ± 2.1) indicating a good and improved knowledge of schistosomiasis among the participants. Furthermore, the paired samples t-test results demonstrated that the increase in knowledge levels was statistically significant (p<0.001). Also, the post-intervention improvement of both practice (p<0.001) and attitude (p<0.001) levels was statistically significant. A positive correlation (r=0.23, p<0.001) was found between knowledge and attitude in the pre-intervention stage. Knowledgeable participants had a more positive attitude towards obtaining medical assistance and disease prevention. Moreover, attitudes and practices correlated negatively (r=-0.13, p=0.013) post-intervention; hence, those with positive attitudes did not engage in risky water-related practices, which was the desired outcome. The educational intervention had a favourable impact on the KAP of the study population as the majority were able to recall the disease aetiology, symptoms, transmission pattern, and preventative measures three months post-intervention. Nevertheless, previous research has suggested that participants were unable to recall information about the disease following the intervention. Consequently, research should prioritize behavioural modification strategies that may result in a more persistent outcome in terms of the participants' knowledge, which could ultimately contribute to the development of long-term positive attitudes and practices.

Keywords: educational intervention, knowledge, attitudes and practices, schistosomiasis

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623 Climate Change and Perceived Socialization: The Role of Parents’ Climate Change Coping Style and Household Communication

Authors: Estefanya Vazquez-Casaubon, Veroline Cauberghe, Dieneke Van de Sompel, Hayley Pearce

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Working together to reduce the anthropogenic impact should be a collective action, including effort within the household. In the matter, children are considered to have an important role in influencing the household to reduce the environmental impact through reversed socialization where children motivate and increase the concern of the parents towards environmental protection. Previous studies reveal that communication between parents and kids is key for effective reversed socialization. However, multiple barriers have been identified in the literature, such as the acceptance of the influence from the kids, the properties of the communication, among other factors. Based on the previous evidence, the present study aims to assess barriers and facilitators of communication at the household level that have an impact on reversed socialization. More precisely, the study examines how parents’ climate change coping strategy (problem-focused, meaning-focused, disregarding) influences the valence and the type of the communication related to climate change, and eventually the extent to which they report their beliefs and behaviours to be influenced by the pro-environmental perspectives of their children; i.e. reversed socialization. Via an online survey, 723 Belgian parents self-reported on communication about environmental protection and risk within their household (such as the frequency of exchange about topics related to climate change sourced from school, the household rules, imparting knowledge to the children, and outer factors like media or peer pressure, the emotional valence of the communication), their perceived socialization, and personal factors (coping mechanisms towards climate change). The results, using structural equation modelling, revealed that parents applying a problem-solving coping strategy related to climate change, appear to communicate more often in a positive than in a negative manner. Parents with a disregarding coping style towards climate change appear to communicate less often in a positive way within the household. Parents that cope via meaning-making of climate change showed to communicate less often in either a positive or negative way. Moreover, the perceived valence of the communication (positive or negative) influenced the frequency and type of household communication. Positive emotions increased the frequency of the communication overall. However, the direct effect of neither of the coping mechanisms on the reversed socialization was significant. High frequency of communication about the media, environmental views of the household members among other external topics had a positive impact on the perceived socialization, followed by discussions school-related; while parental instructing had a negative impact on the perceived socialization. Moreover, the frequency of communication was strongly affected by the perceived valence of the communication (positive or negative). The results go in line with previous evidence that a higher frequency of communication facilitates reversed socialization. Hence the results outstand how the coping mechanisms of the parents can be either a facilitator when they cope via problem-solving, while parents that disregard might avert frequent communication about climate change at the household.

Keywords: communication, parents’ coping mechanisms, environmental protection, household, perceived socialization

Procedia PDF Downloads 88
622 The Role of Emotions in Addressing Social and Environmental Issues in Ethical Decision Making

Authors: Kirsi Snellman, Johannes Gartner, , Katja Upadaya

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A transition towards a future where the economy serves society so that it evolves within the safe operating space of the planet calls for fundamental changes in the way managers think, feel and act, and make decisions that relate to social and environmental issues. Sustainable decision-making in organizations are often challenging tasks characterized by trade-offs between environmental, social and financial aspects, thus often bringing forth ethical concerns. Although there have been significant developments in incorporating uncertainty into environmental decision-making and measuring constructs and dimensions in ethical behavior in organizations, the majority of sustainable decision-making models are rationalist-based. Moreover, research in psychology indicates that one’s readiness to make a decision depends on the individual’s state of mind, the feasibility of the implied change, and the compatibility of strategies and tactics of implementation. Although very informative, most of this extant research is limited in the sense that it often directs attention towards the rational instead of the emotional. Hence, little is known about the role of emotions in sustainable decision making, especially in situations where decision-makers evaluate a variety of options and use their feelings as a source of information in tackling the uncertainty. To fill this lacuna, and to embrace the uncertainty and perceived risk involved in decisions that touch upon social and environmental aspects, it is important to add emotion to the evaluation when aiming to reach the one right and good ethical decision outcome. This analysis builds on recent findings in moral psychology that associate feelings and intuitions with ethical decisions and suggests that emotions can sensitize the manager to evaluate the rightness or wrongness of alternatives if ethical concerns are present in sustainable decision making. Capturing such sensitive evaluation as triggered by intuitions, we suggest that rational justification can be complemented by using emotions as a tool to tune in to what feels right in making sustainable decisions. This analysis integrates ethical decision-making theories with recent advancements in emotion theories. It determines the conditions under which emotions play a role in sustainability decisions by contributing to a personal equilibrium in which intuition and rationality are both activated and in accord. It complements the rationalist ethics view according to which nothing fogs the mind in decision making so thoroughly as emotion, and the concept of cheater’s high that links unethical behavior with positive affect. This analysis contributes to theory with a novel theoretical model that specifies when and why managers, who are more emotional, are, in fact, more likely to make ethical decisions than those managers who are more rational. It also proposes practical advice on how emotions can convert the manager’s preferences into choices that benefit both common good and one’s own good throughout the transition towards a more sustainable future.

Keywords: emotion, ethical decision making, intuition, sustainability

Procedia PDF Downloads 137
621 Branched Chain Amino Acid Kinesio PVP Gel Tape from Extract of Pea (Pisum sativum L.) Based on Ultrasound-Assisted Extraction Technology

Authors: Doni Dermawan

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Modern sports competition as a consequence of the increase in the value of the business and entertainment in the field of sport has been demanding athletes to always have excellent physical endurance performance. Physical exercise is done in a long time, and intensive may pose a risk of muscle tissue damage caused by the increase of the enzyme creatine kinase. Branched Chain Amino Acids (BCAA) is an essential amino acid that is composed of leucine, isoleucine, and valine which serves to maintain muscle tissue, keeping the immune system, and prevent further loss of coordination and muscle pain. Pea (Pisum sativum L.) is a kind of leguminous plants that are rich in Branched Chain Amino Acids (BCAA) where every one gram of protein pea contains 82.7 mg of leucine; 56.3 mg isoleucine; and 56.0 mg of valine. This research aims to develop Branched Chain Amino Acids (BCAA) from pea extract is applied in dosage forms Gel PVP Kinesio Tape technology using Ultrasound-assisted Extraction. The method used in the writing of this paper is the Cochrane Collaboration Review that includes literature studies, testing the quality of the study, the characteristics of the data collection, analysis, interpretation of results, and clinical trials as well as recommendations for further research. Extraction of BCAA in pea done using ultrasound-assisted extraction technology with optimization variables includes the type of solvent extraction (NaOH 0.1%), temperature (20-250C), time (15-30 minutes) power (80 watt) and ultrasonic frequency (35 KHz). The advantages of this extraction method are the level of penetration of the solvent into the membrane of the cell is high and can increase the transfer period so that the BCAA substance separation process more efficient. BCAA extraction results are then applied to the polymer PVP (Polyvinylpyrrolidone) Gel powder composed of PVP K30 and K100 HPMC dissolved in 10 mL of water-methanol (1: 1) v / v. Preparations Kinesio Tape Gel PVP is the BCAA in the gel are absorbed into the muscle tissue, and joints through tensile force then provides stimulation to the muscle circulation with variable pressure so that the muscle can increase the biomechanical movement and prevent damage to the muscle enzyme creatine kinase. Analysis and evaluation of test preparation include interaction, thickness, weight uniformity, humidity, water vapor permeability, the levels of the active substance, content uniformity, percentage elongation, stability testing, release profile, permeation in vitro and in vivo skin irritation testing.

Keywords: branched chain amino acid, BCAA, Kinesio tape, pea, PVP gel, ultrasound-assisted extraction

Procedia PDF Downloads 292
620 Determinants of Maternal Near-Miss among Women in Public Hospital Maternity Wards in Northern Ethiopia: A Facility Based Case-Control Study

Authors: Dejene Ermias Mekango, Mussie Alemayehu, Gebremedhin Berhe Gebregergs, Araya Abrha Medhanye, Gelila Goba

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Background: Maternal near miss (MNM) can be used as a proxy indicator of maternal mortality ratio. There is a huge gap in life time risk between Sub-Saharan Africa and developed countries. In Ethiopia, a significant number of women die each year from complications during pregnancy, childbirth and the post-partum period. Besides, a few studies have been performed on MNM, and little is known regarding determinant factors. This study aims to identify determinants of MNM among women in Tigray region, Northern Ethiopia. Methods: a case-control study in hospital found in Tigray region, Ethiopia was conducted from January 30 - March 30, 2016. The sample included 103 cases and 205 controls recruited from women seeking obstetric care at six public hospitals. Clients having a life-threatening obstetric complication including haemorrhage, hypertensive diseases of pregnancy, dystocia, infections, and anemia or clinical signs of severe anemia in women without haemorrhage were taken as cases and those with normal obstetric outcomes were considered as controls. Cases were selected based on proportional to size allocation while systematic sampling was employed for controls. Data were analyzed using SPSS version 20.0. Binary and multiple variable logistic regression (odds ratio) analyses were calculated with 95% CI. Results: The largest proportion of cases and controls was among the ages of20–29 years, accounting for37.9 %( 39) of cases and 31.7 %( 65) of controls. Roughly 90% of cases and controls were married. About two-thirds of controls and 45.6 %( 47) of cases had gestational age between 37-41 weeks. History of chronic medical conditions was reported in 55.3 %(57) of cases and 33.2%(68) of controls. Women with no formal education [AOR=3.2;95%CI:1.24, 8.12],being less than 16 years old at first pregnancy [AOR=2.5; 95%CI:1.12,5.63],induced labor[AOR=3; 95%CI:1.44, 6.17], history of Cesarean section (C-section) [AOR=4.6; 95%CI: 1.98, 7.61] or chronic medical disorder[AOR=3.5;95%CI:1.78, 6.93], and women who traveled more than 60 minutes before reaching their final place of care[AOR=2.8;95% CI: 1.19,6.35] all had higher odds of experiencing MNM. Conclusions: The Government of Ethiopia should continue its effort to address the lack of road and health facility access as well as education, which will help reduce MNM. Work should also be continued to educate women and providers about common predictors of MNM like the history of C-section, chronic illness, and teenage pregnancy. These efforts should be carried out at the facility, community, and individual levels. The targeted follow-up to women with a history of chronic disease and C-section could also be a practical way to reduce MNM.

Keywords: maternal near miss, severe obstetric hemorrhage, hypertensive disorder, c-section, Tigray, Ethiopia

Procedia PDF Downloads 226
619 A Multifactorial Algorithm to Automate Screening of Drug-Induced Liver Injury Cases in Clinical and Post-Marketing Settings

Authors: Osman Turkoglu, Alvin Estilo, Ritu Gupta, Liliam Pineda-Salgado, Rajesh Pandey

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Background: Hepatotoxicity can be linked to a variety of clinical symptoms and histopathological signs, posing a great challenge in the surveillance of suspected drug-induced liver injury (DILI) cases in the safety database. Additionally, the majority of such cases are rare, idiosyncratic, highly unpredictable, and tend to demonstrate unique individual susceptibility; these qualities, in turn, lend to a pharmacovigilance monitoring process that is often tedious and time-consuming. Objective: Develop a multifactorial algorithm to assist pharmacovigilance physicians in identifying high-risk hepatotoxicity cases associated with DILI from the sponsor’s safety database (Argus). Methods: Multifactorial selection criteria were established using Structured Query Language (SQL) and the TIBCO Spotfire® visualization tool, via a combination of word fragments, wildcard strings, and mathematical constructs, based on Hy’s law criteria and pattern of injury (R-value). These criteria excluded non-eligible cases from monthly line listings mined from the Argus safety database. The capabilities and limitations of these criteria were verified by comparing a manual review of all monthly cases with system-generated monthly listings over six months. Results: On an average, over a period of six months, the algorithm accurately identified 92% of DILI cases meeting established criteria. The automated process easily compared liver enzyme elevations with baseline values, reducing the screening time to under 15 minutes as opposed to multiple hours exhausted using a cognitively laborious, manual process. Limitations of the algorithm include its inability to identify cases associated with non-standard laboratory tests, naming conventions, and/or incomplete/incorrectly entered laboratory values. Conclusions: The newly developed multifactorial algorithm proved to be extremely useful in detecting potential DILI cases, while heightening the vigilance of the drug safety department. Additionally, the application of this algorithm may be useful in identifying a potential signal for DILI in drugs not yet known to cause liver injury (e.g., drugs in the initial phases of development). This algorithm also carries the potential for universal application, due to its product-agnostic data and keyword mining features. Plans for the tool include improving it into a fully automated application, thereby completely eliminating a manual screening process.

Keywords: automation, drug-induced liver injury, pharmacovigilance, post-marketing

Procedia PDF Downloads 157
618 Germline Mutations of Mitogen-Activated Protein Kinases Pathway Signaling Pathway Genes in Children

Authors: Nouha Bouayed Abdelmoula, Rim Louati, Nawel Abdellaoui, Balkiss Abdelmoula, Oldez Kaabi, Walid Smaoui, Samir Aloulou

Abstract:

Background and Aims: Cardiofaciocutaneous syndrome (CFC) is an autosomal dominant disorder with the vast majority of cases arising by a new mutation of BRAF, MEK1, MEK2, or rarely, KRAS genes. Here, we report a rare Tunisian case of CFC syndrome for whom we identify SOS1 mutation. Methods: Genomic DNA was obtained from peripheral blood collected in an EDTA tube and extracted from leukocytes using the phenol/chloroform method according to standard protocols. High resolution melting (HRM) analysis for screening of mutations in the entire coding sequence of PTPN11 was conducted first. Then, HRM assays to look for hot spot mutations coding regions of the other genes of the RAS-MAPK pathway (RAt Sarcoma viral oncogene homolog Mitogen-Activated Protein Kinases Pathway): SOS1, SHOC2, KRAS, RAF1, KRAS, NRAS, CBL, BRAF, MEK1, MEK2, HRAS, and RIT1, were applied. Results: Heterozygous SOS1 point mutation clustered in exon 10, which encodes for the PH domain of SOS1, was identified: c.1655 G > A. The patient was a 9-year-old female born from a consanguineous couple. She exhibited pulmonic valvular stenosis as congenital heart disease. She had facial features and other malformations of Noonan syndrome, including macrocephaly, hypertelorism, ptosis, downslanting palpebral fissures, sparse eyebrows, a short and broad nose with upturned tip, low-set ears, high forehead commonly associated with bitemporal narrowing and prominent supraorbital ridges, short and/or webbed neck and short stature. However, the phenotype is also suggestive of CFC syndrome with the presence of more severe ectodermal abnormalities, including curly hair, keloid scars, hyperkeratotic skin, deep plantar creases, and delayed permanent dentition with agenesis of the right maxillary first molar. Moreover, the familial history of the patient revealed recurrent brain malignancies in the paternal family and epileptic disease in the maternal family. Conclusions: This case report of an overlapping RASopathy associated with SOS1 mutation and familial history of brain tumorigenesis is exceptional. The evidence suggests that RASopathies are truly cancer-prone syndromes, but the magnitude of the cancer risk and the types of cancer partially overlap.

Keywords: cardiofaciocutaneous syndrome, CFC, SOS1, brain cancer, germline mutation

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617 Synthesis, Molecular Modeling and Study of 2-Substituted-4-(Benzo[D][1,3]Dioxol-5-Yl)-6-Phenylpyridazin-3(2H)-One Derivatives as Potential Analgesic and Anti-Inflammatory Agents

Authors: Jyoti Singh, Ranju Bansal

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Fighting pain and inflammation is a common problem faced by physicians while dealing with a wide variety of diseases. Since ancient time nonsteroidal anti-inflammatory agents (NSAIDs) and opioids have been the cornerstone of treatment therapy, however, the usefulness of both these classes is limited due to severe side effects. NSAIDs, which are mainly used to treat mild to moderate inflammatory pain, induce gastric irritation and nephrotoxicity whereas opioids show an array of adverse reactions such as respiratory depression, sedation, and constipation. Moreover, repeated administration of these drugs induces tolerance to the analgesic effects and physical dependence. Further discovery of selective COX-2 inhibitors (coxibs) suggested safety without any ulcerogenic side effects; however, long-term use of these drugs resulted in kidney and hepatic toxicity along with an increased risk of secondary cardiovascular effects. The basic approaches towards inflammation and pain treatment are constantly changing, and researchers are continuously trying to develop safer and effective anti-inflammatory drug candidates for the treatment of different inflammatory conditions such as osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, psoriasis and multiple sclerosis. Synthetic 3(2H)-pyridazinones constitute an important scaffold for drug discovery. Structure-activity relationship studies on pyridazinones have shown that attachment of a lactam at N-2 of the pyridazinone ring through a methylene spacer results in significantly increased anti-inflammatory and analgesic properties of the derivatives. Further introduction of the heterocyclic ring at lactam nitrogen results in improvement of biological activities. Keeping in mind these SAR studies, a new series of compounds were synthesized as shown in scheme 1 and investigated for anti-inflammatory, analgesic, anti-platelet activities and docking studies. The structures of newly synthesized compounds have been established by various spectroscopic techniques. All the synthesized pyridazinone derivatives exhibited potent anti-inflammatory and analgesic activity. Homoveratryl substituted derivative was found to possess highest anti-inflammatory and analgesic activity displaying 73.60 % inhibition of edema at 40 mg/kg with no ulcerogenic activity when compared to standard drugs indomethacin. Moreover, 2-substituted-4-benzo[d][1,3]dioxole-6-phenylpyridazin-3(2H)-ones derivatives did not produce significant changes in bleeding time and emerged as safe agents. Molecular docking studies also illustrated good binding interactions at the active site of the cyclooxygenase-2 (hCox-2) enzyme.

Keywords: anti-inflammatory, analgesic, pyridazin-3(2H)-one, selective COX-2 inhibitors

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616 The Relationship between 21st Century Digital Skills and the Intention to Start a Digit Entrepreneurship

Authors: Kathrin F. Schneider, Luis Xavier Unda Galarza

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In our modern world, few are the areas that are not permeated by digitalization: we use digital tools for work, study, entertainment, and daily life. Since technology changes rapidly, skills must adapt to the new reality, which gives a dynamic dimension to the set of skills necessary for people's academic, professional, and personal success. The concept of 21st-century digital skills, which includes skills such as collaboration, communication, digital literacy, citizenship, problem-solving, critical thinking, interpersonal skills, creativity, and productivity, have been widely discussed in the literature. Digital transformation has opened many economic opportunities for entrepreneurs for the development of their products, financing possibilities, and product distribution. One of the biggest advantages is the reduction in cost for the entrepreneur, which has opened doors not only for the entrepreneur or the entrepreneurial team but also for corporations through intrapreneurship. The development of students' general literacy level and their digital competencies is crucial for improving the effectiveness and efficiency of the learning process, as well as for students' adaptation to the constantly changing labor market. The digital economy allows a free substantial increase in the supply share of conditional and also innovative products; this is mainly achieved through 5 ways to reduce costs according to the conventional digital economy: search costs, replication, transport, tracking, and verification. Digital entrepreneurship worldwide benefits from such achievements. There is an expansion and democratization of entrepreneurship thanks to the use of digital technologies. The digital transformation that has been taking place in recent years is more challenging for developing countries, as they have fewer resources available to carry out this transformation while offering all the necessary support in terms of cybersecurity and educating their people. The degree of digitization (use of digital technology) in a country and the levels of digital literacy of its people often depend on the economic level and situation of the country. Telefónica's Digital Life Index (TIDL) scores are strongly correlated with country wealth, reflecting the greater resources that richer countries can contribute to promoting "Digital Life". According to the Digitization Index, Ecuador is in the group of "emerging countries", while Chile, Colombia, Brazil, Argentina, and Uruguay are in the group of "countries in transition". According to Herrera Espinoza et al. (2022), there are startups or digital ventures in Ecuador, especially in certain niches, but many of the ventures do not exceed six months of creation because they arise out of necessity and not out of the opportunity. However, there is a lack of relevant research, especially empirical research, to have a clearer vision. Through a self-report questionnaire, the digital skills of students will be measured in an Ecuadorian private university, according to the skills identified as the six 21st-century skills. The results will be put to the test against the variable of the intention to start a digital venture measured using the theory of planned behavior (TPB). The main hypothesis is that high digital competence is positively correlated with the intention to start digital entrepreneurship.

Keywords: new literacies, digital transformation, 21st century skills, theory of planned behavior, digital entrepreneurship

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615 Crop Breeding for Low Input Farming Systems and Appropriate Breeding Strategies

Authors: Baye Berihun Getahun, Mulugeta Atnaf Tiruneh, Richard G. F. Visser

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Resource-poor farmers practice low-input farming systems, and yet, most breeding programs give less attention to this huge farming system, which serves as a source of food and income for several people in developing countries. The high-input conventional breeding system appears to have failed to adequately meet the needs and requirements of 'difficult' environments operating under this system. Moreover, the unavailability of resources for crop production is getting for their peaks, the environment is maltreated by excessive use of agrochemicals, crop productivity reaches its plateau stage, particularly in the developed nations, the world population is increasing, and food shortage sustained to persist for poor societies. In various parts of the world, genetic gain at the farmers' level remains low which could be associated with low adoption of crop varieties, which have been developed under high input systems. Farmers usually use their local varieties and apply minimum inputs as a risk-avoiding and cost-minimizing strategy. This evidence indicates that the conventional high-input plant breeding system has failed to feed the world population, and the world is moving further away from the United Nations' goals of ending hunger, food insecurity, and malnutrition. In this review, we discussed the rationality of focused breeding programs for low-input farming systems and, the technical aspect of crop breeding that accommodates future food needs and its significance for developing countries in the decreasing scenario of resources required for crop production. To this end, the application of exotic introgression techniques like polyploidization, pan-genomics, comparative genomics, and De novo domestication as a pre-breeding technique has been discussed in the review to exploit the untapped genetic diversity of the crop wild relatives (CWRs). Desired recombinants developed at the pre-breeding stage are exploited through appropriate breeding approaches such as evolutionary plant breeding (EPB), rhizosphere-related traits breeding, and participatory plant breeding approaches. Populations advanced through evolutionary breeding like composite cross populations (CCPs) and rhizosphere-associated traits breeding approach that provides opportunities for improving abiotic and biotic soil stress, nutrient acquisition capacity, and crop microbe interaction in improved varieties have been reviewed. Overall, we conclude that low input farming system is a huge farming system that requires distinctive breeding approaches, and the exotic pre-breeding introgression techniques and the appropriate breeding approaches which deploy the skills and knowledge of both breeders and farmers are vital to develop heterogeneous landrace populations, which are effective for farmers practicing low input farming across the world.

Keywords: low input farming, evolutionary plant breeding, composite cross population, participatory plant breeding

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614 Acceptability of ‘Fish Surimi Peptide’ in Under Five Children Suffering from Moderate Acute Malnutrition in Bangladesh

Authors: M. Iqbal Hossain, Azharul Islam Khan, S. M. Rafiqul Islam, Tahmeed Ahmed

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Objective: Moderate acute malnutrition (MAM) is a major cause of morbidity and mortality in under-5 children of low-income countries. Approximately 14.6% of all under-5 mortality worldwide is attributed to MAM with >3 times increased risk of death compared to well-nourished peers. Prevalence of MAM among under-5 children in Bangladesh is ~12% (~1.7 million). Providing a diet containing adequate nutrients is the mainstay of treatment of children with MAM. It is now possible to process fish into fish peptides with longer shelf-life without refrigerator, known as ‘Fish Surimi peptide’ and this could be an attractive alternative to supply fish protein in the diet of children in low-income countries like Bangladesh. We conducted this study to assess the acceptability of Fish Surimi peptide given with various foods/meals in 2-5 years old children with MAM. Design/methods: Fish Surimi peptide is broken down from white fish meat using plant-derived enzyme and the ingredient is just fish meat consisted of 20 different kinds of amino acids including nine essential amino acids. In a convenience sample of 34 children we completed the study ward of Dhaka Hospital of icddr,b in Bangladesh during November 2014 through February 2015. For each child the study was for two consecutive days: i.e. direct observation of food intake of two lunches and two suppers. In a randomly and blinded manner and cross over design an individual child received Fish Surimi peptide (5g at lunch and 5g at supper) mixed meal [e.g. 30g rice and 30g dahl (thick lentil soup) or 60g of a vegetables-lentil-rice mixed local dish known as khichuri in one day and the same meal on other day without any Fish Surimi peptide. We observed the completeness and eagerness of eating and any possible side effect (e.g. allergy, vomiting, diarrhea etc.) over these two days. Results: The mean±SD age of the enrolled children was 38.4±9.4 months, weight 11.22±1.41 kg, height 91.0±6.3 cm, and WHZ was -2.13±0.76. Their mean±SD total feeding time (minutes) for lunch was 25.4±13.6 vs. 20.6±11.1 (p=0.130) and supper was 22.3±9.7 vs. 19.7±11.2 (p=0.297), and total amount (g) of food eaten in lunch and supper was found similar 116.1±7.0 vs. 117.7±8.0 (p=3.01) in A (Fish Surimi) and B group respectively. Score in Hedonic scale by mother on test of food given to children at lunch or supper was 3.9±0.2 vs. 4.0±0.2 (p=0.317) and on overall acceptance (including the texture, smell, and appearance) of food at lunch or supper was 3.9±0.2 vs. 4.0±0.2 (p=0.317) for A and B group respectively. No adverse event was observed in any food group during the study period. Conclusions: Fish Surimi peptide may be a cost effective supplementary food, which should be tested by appropriately designed randomized community level intervention trial both in wasted children and stunted children.

Keywords: protein-energy malnutrition, moderate acute malnutrition, weight-for-height z-score, mid upper arm circumference, acceptability, fish surimi peptide, under-5 children

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613 Missed Opportunities for Immunization of under Five Children in Calabar South County Cros River State, Nigeria, the Way Forward

Authors: Celestine Odigwe, Epoke Lincoln, Rhoda-Dara Ephraim

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Background; Immunization against the childhood killer diseases is the cardinal strategy for the prevention of these diseases all over the world in under five children, these diseases include; Tuberculosis, Measles, Polio, Tetanus, Diphthria, Pertusis, Yellow Fever, Hepatitis B, Haemophilus Influenza type B. 6.9 million children die before their fifth birthday , 80% of the worlds death in children under 5 years occur in 25 countries most in Africa and Asia and 2 million children can be saved each year with routine immunization Therefore failure to achieve total immunization coverage puts several children at risk. Aim; The aim of the study was to ascertain the prevalence, Investigate the various reasons and causes why several under five children in a suburb of calabar municipal county fail to get the required immunizations as at and when due and possibly the consequences, so that efforts can be re-directed towards the solution of the problems so identified. Methods; the study was a community based cross sectional study. The respondents were the mothers/guardians of the sampled children who were all aged 0-59 months. To be eligible for recruitment into the study, the parent or guardian was required to give an informed consent, reside within the Calabar South County with his/her children aged 0-59 months. We calculated our sample size using the Leslie-Kish formula and we used a two-staged sampling method, first to ballot for the wards to be involved and then to select four of the most populated ones in the wards chosen. Data collection was by interviewer administered structured questionnaire (Appendix I), Data collected was entered and analyzed using Statistical Package for the Social Sciences (SPSS) Version 20. Percentages were calculated and represented using charts and tables Results; The number of children sampled was 159. We found that 150 were fully immunized and 9 were not, the prevalence of missed opportunity was 32% from the study. The reasons for missed opportunities were varied, ranging from false contraindications, logistical problems resulting in very poor access roads to health facilities and poor organization of health centers together with negative health worker attitudes. Some of the consequences of these missed opportunities were increased susceptibility to vaccine preventable diseases, resurgence of the above diseases and increased morbidity and mortality of children aged less than 5 years. Conclusion; We found that ignorance on the part of both parents/guardians and health care staff together with infrastructural inadequacies in the county such as- roads, poor electric power supply for storage of vaccines were hugely responsible for most missed opportunities for immunization. The details of these and suggestions for improvement and the way forward are discussed.

Keywords: missed opportunity, immunization, under five, Calabar south

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