Search results for: pollution risk assessment

Authors: Zachary Huffman, Joana Rocha

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Wall-pressure fluctuations induced by the turbulent boundary layer (TBL) developed over aircraft are a significant source of aircraft cabin noise. Since the power spectral density (PSD) of these pressure fluctuations is directly correlated with the amount of sound radiated into the cabin, the development of accurate empirical models that predict the PSD has been an important ongoing research topic. The sound emitted can be represented from the pressure fluctuations term in the Reynoldsaveraged Navier-Stokes equations (RANS). Therefore, early TBL empirical models (including those from Lowson, Robertson, Chase, and Howe) were primarily derived by simplifying and solving the RANS for pressure fluctuation and adding appropriate scales. Most subsequent models (including Goody, Efimtsov, Laganelli, Smol’yakov, and Rackl and Weston models) were derived by making modifications to these early models or by physical principles. Overall, these models have had varying levels of accuracy, but, in general, they are most accurate under the specific Reynolds and Mach numbers they were developed for, while being less accurate under other flow conditions. Despite this, recent research into the possibility of using alternative methods for deriving the models has been rather limited. More recent studies have demonstrated that an artificial neural network model was more accurate than traditional models and could be applied more generally, but the accuracy of other machine learning techniques has not been explored. In the current study, an original model is derived using a stepwise regression algorithm in the statistical programming language R, and TBL wall-pressure fluctuations PSD data gathered at the Carleton University wind tunnel. The theoretical advantage of a stepwise regression approach is that it will automatically filter out redundant or uncorrelated input variables (through the process of feature selection), and it is computationally faster than machine learning. The main disadvantage is the potential risk of overfitting. The accuracy of the developed model is assessed by comparing it to independently sourced datasets.

Keywords: aircraft noise, machine learning, power spectral density models, regression models, turbulent boundary layer wall-pressure fluctuations

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Authors: Memory Ranga, Phillip Pretorious

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The South African Government has invested a lot of money in Information Technology Governance (ITG) within the Government departments. The ITG framework was spearheaded by the Department of Public Service and Administration (DPSA). This led to the development of a governing ITG DPSA framework and later the Government Wide Enterprise Architecture (GWEA) Framework for assisting the departments to implement ITG. In addition to this, the government departments have adopted the Information Systems Audit and Control Association (ISACA) Control Objectives for Information and Related Technology (COBIT) for ITG processes. Despite all these available frameworks, departments fail to fully capitalise and improve the ITG processes mainly as these are too generic and difficult to apply for specific governance needs. There has been less research done to evaluate the progress on ITG initiatives within the government departments. This paper aims to evaluate the existing ITG frameworks within selected government departments in South Africa. A quantitative research approach was used in this study. Data was collected through an online questionnaire targeting ICT Managers and Directors from government departments. The study is undertaken within a case study and only the Eastern Cape Province was selected for the research. Document review mainly on ITG framework and best practices was also used. Data was analysed using the Google Analytic tools and SPSS. A one–sample Chi-Squared Test was used to verity the evaluation findings. Findings show that there is evidence that the current guiding National governance framework (DPSA) is out dated and does not accommodate the new changes in other governance frameworks. The Eastern Cape Government Departments have spent huge amount of money on ITG but not yet able to identify the benefits of the ITG initiatives. The guiding framework is rigid and does to address some of the departmental needs making it difficult to be flexible and apply the DPSA framework. Furthermore, despite the large budget on ITG, the departments still find themselves with many challenges and unable to improve some of the processes and services. All the engaged Eastern Cape departments have adopted the COBIT framework, but none has been conducting COBIT maturity Assessment which is a functionality of COBIT. There is evidence of too many the ITG frameworks and underutilisation of these frameworks. The study provides a comprehensive evaluation of the ITG frameworks that have been adopted by the South African Government Departments in the Eastern Cape Province. The evaluation guides and recommends the government departments to rethink and adopt ITG frameworks that could be customised to accommodate their needs. The adoption and application of ITG by government departments should assist in better governance and service delivery to the citizens.

Keywords: information technology governance, COBIT, evaluate, framework, governance, DPSA framework

Procedia PDF Downloads 124

Authors: Jayanta Kumar Mahato, Partha Sarathi De, Amrita Kundu, P. C. Chakraborti

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Ratcheting is one of the most important phenomena to be considered for design and safety assessment of structural components subjected to stress controlled asymmetric cyclic loading in the elasto-plastic domain. In the present study uniaxial ratcheting behavior of commercially pure annealed OFHC copper and aluminium with two different grain sizes has been investigated. Stress-controlled tests have been conducted at various combinations of stress amplitude and mean stress. These stresses were selected in such a way that the ratio of equivalent stress amplitude (σₐeq) to ultimate tensile strength (σUTS) of the selected materials remains constant. It is found that irrespective of grain size the ratcheting fatigue lives decrease with the increase of both stress amplitude and mean stress following power relationships. However, the effect of stress amplitude on ratcheting lives is observed higher as compared to mean stress for both the FCC metals. It is also found that for both FCC metals ratcheting fatigue lives at a constant ratio of equivalent stress amplitude (σ ₐeq) to ultimate tensile strength (σUTS) are more in case fine grain size. So far ratcheting strain rate is concerned, it decreases rapidly within first few cycles and then a steady state is reached. Finally, the ratcheting strain rate increases up to the complete failure of the specimens due to a very large increase of true stress for a substantial reduction in cross-sectional area. The steady state ratcheting strain rate increases with the increase in both stress amplitude and mean stress. Interestingly, a unique perfectly power relationship between steady state ratcheting strain rate and cycles to failure has been found irrespective of stress combination for both FCC metals. Similar to ratcheting strain rate, the strain energy density decreases rapidly within first few cycles followed by steady state and then increases up to a failure of the specimens irrespective of stress combinations for both FCC metals; but strain energy density at steady state decreases with increase in mean stress and increases with the increase of stress amplitude. From the fractography study, it is found that the void density increases with the increase of maximum stress, but the void size and void density are almost same for any combination of stress parameters considering constant maximum stress.

Keywords: ratcheting phenomena, grain size, stress parameter, ratcheting lives, ratcheting strain rate

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Authors: A. J. Netshipale, M. L. Mashiloane, S. J. Oosting, I. J. M. De Boer, E. N. Raidimi

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Three tier land reform programme (land restitution, land redistribution and land tenure reform) had been implemented for the past two decades in South Africa with an aim of redressing the unjust land ownership patterns of the past. Land restitution and redistribution seeked to make land available for beneficiaries’ ownership based on policy guidelines. Attention given to the two sub-programmes was mostly land reform focused with the quantity of land that exchanged ownership being used as a measure of success with disregard for how the land is used by the beneficiaries for their livelihoods. In few cases that the land use assessment was done for the two sub-programmes it was assessed on a case basis or few selected cases. The current study intended to shed light on a broader scope. This study investigated the extent to which land reform farms were used and contribution made by farms to the livelihoods of active beneficiaries. Seventy six farms that represented restitution (16 farms) and redistribution (60) programmes were selected for land use investigation. Land use data were collected from farm representatives by means of semi-structured questionnaire. A stratified sample of 87 households (38 for restitution and 49 for redistribution) were selected for livelihood investigations. Data on income generating activities and passive income sources were collected from household heads using semi-structured questionnaire. Additional data were collected through focus group discussions and from stakeholders through key-informants interviews. Livestock production used more land per farm on average (45%) in relation to the amount of average total land used per farm of 77% under land redistribution programme. Land restitution transformed crop farms into mixed farming and unused farms to be under use while land redistribution converted conservation land into agricultural land and also unused farms to be used. Livestock production contributed on average 25% to the livelihoods of 48% of the households whereas crop production contributed 31% on average to the livelihoods of 67% of the households. Government grants had the highest contribution of 54% on average and contributed to most households (72%). Agriculture was the sole source of livelihoods to only three per cent of the households. Most households (40%) had a mix of three livelihoods sources as their livelihood strategy. It could be concluded that the use of reformed land would be mainly influenced by the agro-ecological conditions of the area and agriculture could not be the main source of livelihoods for households that benefited from land reform. Land reform policies which accommodate diverse livelihoods activities could contribute to sustainable livelihoods.

Keywords: active beneficiaries, households, land reform, land use, livelihoods

Procedia PDF Downloads 198

Authors: Pranav Gulati, Isha Sharma

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Hypertension and hypotension are known to have repercussions on the health of an individual, with hypertension contributing to an increased probability of risk to cardiovascular diseases and hypotension resulting in syncope. This prompts the development of a non-invasive, non-intrusive, continuous and cuff-less blood pressure monitoring system to detect blood pressure variations and to identify individuals with acute and chronic heart ailments, but due to the unavailability of such devices for practical daily use, it becomes difficult to screen and subsequently regulate blood pressure. The complexities which hamper the steady monitoring of blood pressure comprises of the variations in physical characteristics from individual to individual and the postural differences at the site of monitoring. We propose to develop a continuous, comprehensive cardio-analysis tool, based on reflective photoplethysmography (PPG). The proposed device, in the form of an eyewear captures the PPG signal and estimates the systolic and diastolic blood pressure using a sensor positioned near the temporal artery. This system relies on regression models which are based on extraction of key points from a pair of PPG wavelets. The proposed system provides an edge over the existing wearables considering that it allows for uniform contact and pressure with the temporal site, in addition to minimal disturbance by movement. Additionally, the feature extraction algorithms enhance the integrity and quality of the extracted features by reducing unreliable data sets. We tested the system with 12 subjects of which 6 served as the training dataset. For this, we measured the blood pressure using a cuff based BP monitor (Omron HEM-8712) and at the same time recorded the PPG signal from our cardio-analysis tool. The complete test was conducted by using the cuff based blood pressure monitor on the left arm while the PPG signal was acquired from the temporal site on the left side of the head. This acquisition served as the training input for the regression model on the selected features. The other 6 subjects were used to validate the model by conducting the same test on them. Results show that the developed prototype can robustly acquire the PPG signal and can therefore be used to reliably predict blood pressure levels.

Keywords: blood pressure, photoplethysmograph, eyewear, physiological monitoring

Procedia PDF Downloads 279

Authors: Vrinda Hari Ankolekar, Anne D. Souza, Mamatha Hosapatna

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Introduction: Precise anatomical assessment of femoral neck anteversion (FNA) and the neck shaft angles (NSA) would be essential in diagnosing the pathological conditions involving hip joint and its ligaments. FNA of greater than 20 degrees is considered excessive femoral anteversion, whereas a torsion angle of fewer than 10 degrees is considered femoral retroversion. Excessive femoral torsion is not uncommon and has been associated with certain neurologic and orthopedic conditions. The enlargement and maturation of the hip joint increases at the 20th week of gestation and the NSA ranges from 135- 140◦ at birth. Material and methods: 48 femurs were tagged according to the GA and two photographs for each femur were taken using Nikon digital camera. Each femur was kept on a horizontal hard desk and end on an image of the upper end was taken for the estimation of FNA and a photograph in a perpendicular plane was taken to calculate the NSA. The images were transferred to the computer and were stored in TIFF format. Microsoft Paint software was used to mark the points and Image J software was used to calculate the angles digitally. 1. Calculation of FNA: The midpoint of the femoral head and the neck were marked and a line was drawn joining these two points. The angle made by this line with the horizontal plane was measured as FNA. 2. Calculation of NSA: The midpoint of the femoral head and the neck were marked and a line was drawn joining these two points. A vertical line was drawn passing through the tip of the greater trochanter to the inter-condylar notch. The angle formed by these lines was calculated as NSA. Results: The paired t-test for the inter-observer variability showed no significant difference between the values of two observers. (FNA: t=-1.06 and p=0.31; NSA: t=-0.09 and p=0.9). The FNA ranged from 17.08º to 33.97 º on right and 17.32 º to 45.08 º on left. The NSA ranged from 139.33 º to 124.91 º on right and 143.98 º to 123.8 º on left. Unpaired t-test was applied to compare the mean angles between the second and third trimesters which did not show any statistical significance. This shows that the FNA and NSA of femur did not vary significantly during the third trimester. The FNA and NSA were correlated with the GA using Pearson’s correlation. FNA appeared to increase with the GA (r=0.5) but the increase was not statistically significant. A decrease in the NSA was also noted with the GA (r=-0.3) which was also statistically not significant. Conclusion: The present study evaluates the FNA and NSA of the femur in fetuses and correlates their development with the GA during second and third trimesters. The FNA and NSA did not vary significantly during the third trimester.

Keywords: anteversion, coxa antetorsa, femoral torsion, femur neck shaft angle

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Authors: Kasun U. G. Palihakkara

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Although vaccine coverage in Sri Lanka is close to 100%, with the widely spreading vaccine rejection trend reaching South Asian regions, it is essential to catch on whether Sri Lankans are being misinformed from the common misconceptions regarding vaccines. As the rates of target diseases decrease, parents become less accepting of even minor common adverse events. It is essential to preserve the integrity of immunization programs and protect public health by finding out the prevalence of anti-immunization trends. The primary objective of this study was to assess the immunization practices and prevalence of trends related to anti-immunization among urban community in Sri Lanka. A descriptive cross-sectional quantitative study on 323 participants using convenient sampling with 213 self-administered questionnaires. Additionally, 110 online questionnaires were distributed. 31% of the study population does not maintain immunization records for their children. While majority seek information regarding immunization from reliable sources such as the family physician or specialist pediatricians, 30% also refer to unreliable sources such as online communities for their opinion. 31% of study population had not vaccinated for Japanese encephalitis. 73% of the study population had encountered with side effects of vaccination such as fever & 47% believed that such side effects are rare. 52% of the population had hostile attitude regarding the administration of several doses multiple vaccines within a child’s first year. Diseases like polio had been successfully eradicated from Sri Lanka with the help of vigorous vaccination programs. However, majority of the study population believe that there’s no need to keep vaccinating the children for those eradicated diseases and exposing the child for adverse effects of such vaccines. Majority of the population were aware of the existing misconceptions regarding immunization. The most popular misconceptions about vaccines popular among the study population were the MMR (Measles, Mumps, and Rubella) vaccine being a possible cause leading to autism and bowel disease and children getting infected with the disease even after they get vaccinated, may be due to the inactivated vaccine. Disturbingly 22% of the study population believed that vaccines are useless in preventing diseases nowadays. These data obtained from the urban study population reveals that even though statistically Sri Lankan immunization coverage is 100%, there is a possibility of anti-vaccination trend arising in Sri Lanka due to the prevalence of various misconceptions and rumors related to it. Therefore these data recommend the need for thorough awareness among the mothers.

Keywords: anti-vaccination, immunization, infectious diseases, pediatric health

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Authors: Ábrám Zoltán

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Introduction: Climate change is now a major health risk, and its environmental and health effects have become frequently discussed topics. The consequences of climate change are clearly visible in natural disasters and excess deaths caused by extreme weather conditions. Global warming and the increasingly frequent extreme weather events have direct, immediate effects or long-term, indirect effects on health. For this reason, it is a need to teach the health effects of climate change in medical schools. Material and methods: We looked for various surveys, studies, and reports on the main pathways through which global warming affects health. Medical schools face the challenge of teaching the health implications of climate change and integrating knowledge about the health effects of climate change into medical training. For this purpose, there were organised World Café workshops for three target groups: medical students, academic staff, and practising medical doctors. Results: Among the goals of the research is the development of a detailed curriculum for medical students, which serves to expand their knowledge in basic education. At the same time, the project promotes the increase of teacher motivation and the development of methodological guidelines for university teachers; it also provides further training for practicing doctors. The planned teaching materials will be developed in a format suitable for traditional face-to-face teaching, as well as e-learning teaching materials. CLIMATEMED is a project based on the cooperation of six universities and institutions from four countries, the aim of which is to improve the curriculum and expand knowledge about the health effects of climate change at medical universities. Conclusions: In order to assess the needs, summarize the proposals, to develop the necessary strategy, World Café type, one-and-a-half to two-hour round table discussions will take place separately for medical students, academic staff, and practicing doctors. The CLIMATEMED project can facilitate the integration of knowledge about the health effects of climate change into curricula and can promote practical use. The avoidance of the unwanted effects of global warming and climate change is not only a public matter, but it is also a challenge to change our own lifestyle. It is the responsibility of all of us to protect the Earth's ecosystem and the physical and mental health of ourselves and future generations.

Keywords: climate change, health effects, medical schools, World Café, medical students

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Authors: Hameed Ullah, Shujaul Mulk Khan, Zahid Ullah, Zeeshan Ahmad Sadia Jahangir, Abdullah, Amin Ur Rahman, Muhammad Suliman, Dost Muhammad

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The interrelationship between vegetation and abiotic variables inside an ecosystem is one of the main jobs of plant scientists. This study was designed to investigate the vegetation structure and species diversity along with the environmental variables in the Yakhtangay hill district Shangla of the Himalayan Mountain series Pakistan by using multivariate statistical analysis. Quadrat’s method was used and a total of 171 Quadrats were laid down 57 for Tree, Shrubs and Herbs, respectively, to analyze the phytosociological attributes of the vegetation. The vegetation of the selected area was classified into different Life and leaf-forms according to Raunkiaer classification, while PCORD software version 5 was used to classify the vegetation into different plants communities by Two-way indicator species Analysis (TWINSPAN). The CANOCCO version 4.5 was used for DCA and CCA analysis to find out variation directories of vegetation with different environmental variables. A total of 114 plants species belonging to 45 different families was investigated inside the area. The Rosaceae (12 species) was the dominant family followed by Poaceae (10 species) and then Asteraceae (7 species). Monocots were more dominant than Dicots and Angiosperms were more dominant than Gymnosperms. Among the life forms the Hemicryptophytes and Nanophanerophytes were dominant, followed by Therophytes, while among the leaf forms Microphylls were dominant, followed by Leptophylls. It is concluded that among the edaphic factors such as soil pH, the concentration of soil organic matter, Calcium Carbonates concentration in soil, soil EC, soil TDS, and physiographic factors such as Altitude and slope are affecting the structure of vegetation, species composition and species diversity at the significant level with p-value ≤0.05. The Vegetation of the selected area was classified into four major plants communities and the indicator species for each community was recorded. Classification of plants into 4 different communities based upon edaphic gradients favors the individualistic hypothesis. Indicator Species Analysis (ISA) shows the indicators of the study area are mostly indicators to the Himalayan or moist temperate ecosystem, furthermore, these indicators could be considered for micro-habitat conservation and respective ecosystem management plans.

Keywords: species richness, edaphic gradients, canonical correspondence analysis (CCA), TWCA

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Authors: Theresa Bacon-Baguley, Martina Reinhold

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Introduction: Evaluation and analysis are the cornerstones of any successful program in higher education. When developing a program at a distant campus, it is essential that the process of evaluation and analysis be orchestrated in a timely manner with tools that can identify both the positive and negative components of distant education. We describe the utilization of a newly developed tool used to evaluate and analyze the successful expansion to a distant campus using Telepresence Technology. Like interactive television, Telepresence allows live interactive delivery but utilizes broadband cable. The tool developed is adaptable to any distant campus as the framework for the tool was derived from a systematic review of the literature. Methodology: Because Telepresence is a relatively new delivery system, the evaluation tool was developed based on a systematic review of literature in the area of distant education and ITV. The literature review identified four potential areas of concern: 1) technology, 2) confidence in the system, 3) faculty delivery of the content and, 4) resources at each site. Each of the four areas included multiple sub-components. Benchmark values were determined to be 80% or greater positive responses to each of the four areas and the individual sub-components. The tool was administered each semester during the didactic phase of the curriculum. Results: Data obtained identified site-specific issues (i.e., technology access, student engagement, laboratory access, and resources), as well as issues common at both sites (i.e., projection screen size). More specifically, students at the parent location did not have adequate access to printers or laboratory space, and students at the distant campus did not have adequate access to library resources. The evaluation tool identified that both sites requested larger screens for visualization of the faculty. The deficiencies were addressed by replacing printers, including additional orientation for students on library resources and increasing the screen size of the Telepresence system. When analyzed over time, the issues identified in the tool as deficiencies were resolved. Conclusions: Utilizing the tool allowed adjustments of the Telepresence delivery system in a timely manner resulting in successful implementation of an entire curriculum at a distant campus.

Keywords: physician assistant, telepresence technology, distant education, assessment

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Authors: Siwimol Phoomniyom, Pathom Karaipoom, Rossaphorn Kittyaowaman

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Background: C. trachomatis is the most common bacterial sexually transmitted infections. Although infection with C. trachomatis can be treated with antibiotic, it is frequently asymptomatic, especially in extragenital sites. Hence, if screening tests are not performed, undetected and untreated is a crucial problem for C. trachomatis infection, especially in Thailand, which is less well studied. We sought to assess the prevalence of C. trachomatis infection in multiple anatomical sites among patients attending Bangrak STIs Center. Methods: We examined laboratory results of all patients at baseline visit from 3 January 2018 to 27 December 2019. These results were tested by a validated in-house real time PCR specify for the cryptic plasmid gene of C. trachomatis. The prevalence of C. trachomatis was analyzed by anatomical sites, sexes, and ages. Urogenital samples were obtained from urethral swab of men and cervical swab of women. The median ages of the patients were 32 years (range 13-89 years). Chi-square test by IBM SPSS statistic version 20 was used to assess difference in the distribution of variables between groups. Results: Among 3,789 patients, the prevalence for C. trachomatis infection was the highest in rectal (16.1%), followed by urogenital (11.2%) and pharyngeal (3.5%) sites. Rectal and urogenital infection in men was higher than in women, with the highest prevalence of 16.6% in rectal site. Both rectal and urogenital sites also showed statistically significant differences between sexes (P<0.001). Meanwhile, pharyngeal C. trachomatis infection rate was higher in women than men. Interestingly, the chlamydia prevalence was the highest in age 13-19 years of all three sites (18.5%, urogenital; 17.7%, rectal; 6.5%, pharyngeal), with statistically significant difference between age groups (P<0.001). Total of 45 C. trachomatis infections, 20.0%, 51.1%, and 6.7% were isolated from urogenital, rectal, and pharyngeal sites. In total, 75.6%, 26.7%, and 80.0% of chlamydia infections would have been missed, if only urogenital, rectal, or pharyngeal screening was performed. Conclusions: The highest source of C. trachomatis infection was the rectal site. While, the highest prevalence in men was at rectal site, that in women was at urogenital site. The highest chlamydia prevalence was found in adolescent age group, indicating that the pediatric population was a high-risk group. This finding also elucidated that a high proportion of C. trachomatis infection would be missed, if only single anatomical site screening was performed, especially in extragenital sites. Hence, extragenital screening is also required for the extensive C. trachomatis detection.

Keywords: chlamydia trachomatis, anatomical sites, sexes, ages

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Authors: Adebayo-Victoria Tobi Dada, Dada Emmanuel

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This study assessed households’ food security and hunger levels among different communities with varying educational and economic background in Ile-Ife, Nigeria, and its environment. It also examined the impacts of varying demography on the household food security level in the area. This was with a view to providing information on the food security status of the subjects within the study area. Ten different communities with varying demography (Parakin, Mokuro, Ilare, Obafemi Awolowo University (OAU) Staff Quarters, Ibadan Road, Aba-Iya Gani, Eleweran, Iraye, Boosa, and Eku-Isobo) were identified within the study area. Fieldwork was then carried out from 7th to 14th of March, 2016 in each of these communities through survey of market prices of food stuff, diet, and nutrition, social well-being, food accessibility and affordability as well as price fluctuation and variation in household’s social background. Selection of households for the survey was done using stratified random sampling method. Key informants included community heads, landlords, tenants, and household heads. Similarly, information on food security levels with respect to demographic backgrounds was obtained from the use of modified Food and Hunger Insecurity Module (FHIM) structured questionnaire. The questionnaire was administered to one percent of the households’ population per community. The results showed that communities such as Parakin and OAU Senior Staff Quarters were dominated by civil servants, while community such as Boosa was dominated by artisans. Respondents earning between ₦11,000 and ₦20,000 per month, during the study period, had the highest percentage across the selected communities. The household food security indices showed that about 41% of the investigated respondents could not guarantee their household food for a month, while 18% reduced or skipped meals. There were positive significant relationships between monthly income (F-value = 132.04), educational status (F-value = 102.30), occupation (F-value = 104.05) and food budget (F-value = 122.09), all at p < 0.05. However, there was no significant relationship between the monthly food budget and household sizes (t-value = -1.4074, p > 0.05). Food secured households’ had the household heads with a higher level of educational attainment. The study concluded that large variations which existed between socio-economic and educational background among the communities had significant effects on households’ food security level in the study area.

Keywords: food security, households, hunger level, market prices

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Authors: Stephanie Duval

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The concept of educational success, combined with the overall development of the child in kindergarten, is at the center of current interests, both in research and in the environments responsible for the education of young children. In order to promote it, researchers emphasize the importance of studying the executive functions [EF] of children in preschool education. More precisely, the EFs, which refers to working memory [WM], inhibition, mental flexibility and planning, would be the pivotal element of the child’s educational success. In order to support the EFs of the child, and even his educational success, the quality of the environments is beginning to be explored more and more. The question that arises now is how to promote EFs for young children in the educational environment, in order to support their educational success? The objective of this study is to investigate the link between the quality of interactions in 5-year-old kindergarten and child’s EFs. The sample consists of 118 children (70 girls, 48 boys) in 12 classes. The quality of the interactions is observed from the Classroom Assessment Scoring System [CLASS], and the EFs (i.e., working memory, inhibition, cognitive flexibility, and planning) are measured with administered tests. The hypothesis of this study was that the quality of teacher-child interactions in preschool education, as measured by the CLASS, was associated with the child’s EFs. The results revealed that the quality of emotional support offered by adults in kindergarten, included in the CLASS tool, was positively and significantly related to WM and inhibition skills. The results also suggest that WM is a key skill in the development of EFs, which may be associated with the educational success of the child. However, this hypothesis remains to be clarified, as is the link with educational success. In addition, results showed that factors associated to the family (ex. parents’ income) moderate the relationship between the domain ‘instructional support’ of the CLASS (ex. concept development) and child’s WM skills. These data suggest a moderating effect related to family characteristics in the link between ‘quality of classroom interactions’ and ‘EFs’. This project proposes, as a future avenue, to check the distinctive effect of different environments (familial and educational) on the child’s EFs. More specifically, future study could examine the influence of the educational environment on EF skills, as well as whether or not there is a moderating effect of the family environment (ex. parents' income) on the link between the quality of the interactions in the classroom and the EFs of the children, as anticipated by this research.

Keywords: executive functions [EFs], environmental factors, quality of interactions, preschool education

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Authors: Getahun Nigusie Demise

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Background; antiretroviral treatment reduce HIV-related morbidity, and prolonged survival of patients however, there is lack of up-to-date information concerning the treatment long term effect on the survival of HIV positive children especially in the study area. Objective: The aim of this study is to assess the incidence and predictors of mortality among HIV positive children on antiretroviral therapy (ART) in public hospitals of Harer town who were enrolled from 2011 to 2021. Methodology: Institution based retrospective cohort study was conducted among 429 HIV positive children enrolled in ART clinic from January 1st 2011 to December30th 2021. Data were collected from medical cards by using a data extraction form, Descriptive analyses were used to Summarized the results, and life table was used to estimate survival probability at specific point of time after introduction of ART. Kaplan Meier survival curve together with log rank test was used to compare survival between different categories of covariates, and Multivariate Cox-proportional hazard regression model was used to estimate adjusted Hazard rate. Variables with p-values ≤0.25 in bivariable analysis were candidates to the multivariable analysis. Finally, variables with p-values < 0.05 were considered as significant variables. Results: The study participants had followed for a total of 2549.6 child-years (30596 child months) with an overall mortality rate of 1.5 (95% CI: 1.1, 2.04) per 100 child-years. Their median survival time was 112 months (95% CI: 101–117). There were 38 children with unknown outcome, 39 deaths, and 55 children transfer out to different facility. The overall survival at 6, 12, 24, 48 months were 98%, 96%, 95%, 94% respectively. being in WHO clinical Stage four (AHR=4.55, 95% CI:1.36, 15.24), having anemia(AHR=2.56, 95% CI:1.11, 5.93), baseline low absolute CD4 count (AHR=2.95, 95% CI: 1.22, 7.12), stunting (AHR=4.1, 95% CI: 1.11, 15.42), wasting (AHR=4.93, 95% CI: 1.31, 18.76), poor adherence to treatment (AHR=3.37, 95% CI: 1.25, 9.11), having TB infection at enrollment (AHR=3.26, 95% CI: 1.25, 8.49),and no history of change their regimen(AHR=7.1, 95% CI: 2.74, 18.24), were independent predictors of death. Conclusion: more than half of death occurs within 2 years. Prevalent tuberculosis, anemia, wasting, and stunting nutritional status, socioeconomic factors, and baseline opportunistic infection were independent predictors of death. Increasing early screening and managing those predictors are required.

Keywords: human immunodeficiency virus-positive children, anti-retroviral therapy, survival, treatment, Ethiopia

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Authors: Awadh O. Al-Anazi

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As part of the organizational needs toward successful maintaining activities, a proper management system need to be put in place, ensuring the effectiveness of maintenance activities. The management system shall clearly describes the process of identifying, prioritizing, planning, scheduling, execution, and providing valuable feedback for all maintenance activities. Completion and accuracy of the system with proper implementation shall provide the organization with a strong platform for effective maintenance activities that are resulted in efficient outcomes toward business success. The purpose of this research was to introduce a practical tool for measuring the maintenance efficiency level within Saudi organizations. A comprehensive study was launched across many maintenance professionals throughout Saudi leading organizations. The study covered five main categories: work process, identification, planning and scheduling, execution, and performance monitoring. Each category was evaluated across many dimensions to determine its current effectiveness through a five-level scale from 'process is not there' to 'mature implementation'. Wide participation was received, responses were analyzed, and the study was concluded by highlighting major gaps and improvement opportunities within Saudi organizations. One effective implementation of the efficiency enhancement efforts was deployed in Saudi Kayan (one of Sabic affiliates). Below details describes the project outcomes: SK overall maintenance wrench time was measured at 20% (on average) from the total daily working time. The assessment indicates the appearance of several organizational gaps, such as a high amount of reactive work, poor coordination and teamwork, Unclear roles and responsibilities, as well as underutilization of resources. Multidiscipline team was assigned to design and implement an appropriate work process that is capable to govern the execution process, improve the maintenance workforce efficiency, and maximize wrench time (targeting > 50%). The enhanced work process was introduced through brainstorming and wide benchmarking, incorporated with a proper change management plan and leadership sponsorship. The project was completed in 2018. Achieved Results: SK WT was improved to 50%, which resulted in 1) reducing the Average Notification completion time. 2) reducing maintenance expenses on OT and manpower support (3.6 MSAR Actual Saving from Budget within 6 months).

Keywords: efficiency, enhancement, maintenance, work force, wrench time

Procedia PDF Downloads 146

Authors: Pamela-Zoe Topalli, Niina Junttila, Päivi M. Niemi, Klaus Ranta

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Adolescents’ biased perceptions about their social competence (SC), whether negatively or positively, serve to influence their socioemotional adjustment such as early feelings of social phobia (nowadays referred to as Social Anxiety Disorder-SAD). Despite the importance of biased self-perceptions in adolescents’ psychosocial adjustment, the extent to which discrepancies between self- and others’ evaluations of one’s SC are linked to social phobic symptoms remains unclear in the literature. This study examined the perceptual discrepancy profiles between self- and peers’ as well as between self- and teachers’ evaluations of adolescents’ SC and the interrelations of these profiles with self-reported social phobic symptoms. The participants were 390 3^rd graders (15 years old) of Finnish lower secondary school (50.8% boys, 49.2% girls). In contrast with variable-centered approaches that have mainly been used by previous studies when focusing on this subject, this study used latent profile analysis (LPA), a person-centered approach which can provide information regarding risk profiles by capturing the heterogeneity within a population and classifying individuals into groups. LPA revealed the following five classes of discrepancy profiles: i) extremely negatively biased perceptions of SC, ii) negatively biased perceptions of SC, iii) quite realistic perceptions of SC, iv) positively biased perceptions of SC, and v) extremely positively biased perceptions of SC. Adolescents with extremely negatively biased perceptions and negatively biased perceptions of their own SC reported the highest number of social phobic symptoms. Adolescents with quite realistic, positively biased and extremely positively biased perceptions reported the lowest number of socio-phobic symptoms. The results point out the negatively and the extremely negatively biased perceptions as possible contributors to social phobic symptoms. Moreover, the association of quite realistic perceptions with low number of social phobic symptoms indicates its potential protective power against social phobia. Finally, positively and extremely positively biased perceptions of SC are negatively associated with social phobic symptoms in this study. However, the profile of extremely positively biased perceptions might be linked as well with the existence of externalizing problems such as antisocial behavior (e.g. disruptive impulsivity). The current findings highlight the importance of considering discrepancies between self- and others’ perceptions of one’s SC in clinical and research efforts. Interventions designed to prevent or moderate social phobic symptoms need to take into account individual needs rather than aiming for uniform treatment. Implications and future directions are discussed.

Keywords: adolescence, latent profile analysis, perceptual discrepancies, social competence, social phobia

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Authors: Mohd Taufiq bin Azmy, Yahaya Hassan, Shubashini Gnanasan, Loganathan Fahrni

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Inappropriate prescribing in older patients has been associated with resource utilization and adverse drug events (ADE) such as hospitalization, morbidity and mortality. Globally, there is a lack of published data on ADE induced by inappropriate prescribing. Our study is specific to an older population and is aimed at identifying risk factors for ADE and to develop a model that will link ADE to inappropriate prescribing. The design of the study was prospective whereby computerized medical records of 302 hospitalized elderly aged 65 years and above in 3 public hospitals in Malaysia (Hospital Serdang, Hospital Selayang and Hospital Sungai Buloh) were studied over a 7 month period from September 2013 until March 2014. Potentially inappropriate medications and potential prescribing omissions were determined using the published and validated START-STOPP criteria. Patients who had at least one inappropriate medication were included in Phase II of the study where ADE were identified by local expert consensus panel based on the published and validated Naranjo ADR probability scale. The panel also assessed whether ADE were causal or contributory to current hospitalization. The association between inappropriate prescribing and ADE (hospitalization, mortality and adverse drug reactions) was determined by identifying whether or not the former was causal or contributory to the latter. Rate of ADE avoidability was also determined. Our findings revealed that the prevalence of potential inappropriate prescribing was 58.6%. A total of ADEs were detected in 31 of 105 patients (29.5%) when STOPP criteria were used to identify potentially inappropriate medication; All of the 31 ADE (100%) were considered causal or contributory to admission. Of the 31 ADEs, 28 (90.3%) were considered avoidable or potentially avoidable. After adjusting for age, sex, comorbidity, dementia, baseline activities of daily living function, and number of medications, the likelihood of a serious avoidable ADE increased significantly when a potentially inappropriate medication was prescribed (odds ratio, 11.18; 95% confidence interval [CI], 5.014 - 24.93; p < .001). The medications identified by STOPP criteria, are significantly associated with avoidable ADE in older people that cause or contribute to urgent hospitalization but contributed less towards morbidity and mortality. Findings of the study underscore the importance of preventing inappropriate prescribing.

Keywords: adverse drug events, appropriate prescribing, health services research

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Authors: C. M. Choi, H. C. Tsang, W. K. Fong, Y. K. Cheng, T. K. Chui, L. Y. Chan, K. W. Lee, C. K. Yuen, P. W. Lau, Y. L. To, K. C. Chow

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Six-minute walk test (6MWT) is a sub-maximal exercise test to assess aerobic capacity and exercise tolerance of patients with chronic respiratory disease and heart failure. This has been proven to be a reliable and valid tool and commonly used in clinical situations. Traditional 6MWT is labour-intensive and time-consuming especially for patients who require assistance in ambulation and oxygen use. When performing the test with these patients, one staff will assist the patient in walking (with or without aids) while another staff will need to manually record patient’s oxygen saturation, heart rate and walking distance at every minute and/or carry oxygen cylinder at the same time. Physiotherapist will then have to document the test results in bed notes in details. With the use of electronic 6MWT (E-6MWT), patients wear a wireless oximeter that transfers data to a tablet PC via Bluetooth. Real-time recording of oxygen saturation, heart rate, and distance are displayed. No manual work on recording is needed. The tablet will generate a comprehensive report which can be directly attached to the patient’s bed notes for documentation. Data can also be saved for later patient follow up. This study was carried out in North District Hospital. Patients who followed commands and required 6MWT assessment were included. Patients were assigned to study or control groups. In the study group, patients adopted the E-6MWT while those in control group adopted the traditional 6MWT. Manpower and time consumed were recorded. Physiotherapists also completed a questionnaire about the use of E-6MWT. Total 12 subjects (Study=6; Control=6) were recruited during 11-12/2017. An average number of staff required and time consumed in traditional 6MWT were 1.67 and 949.33 seconds respectively; while in E-6MWT, the figures were 1.00 and 630.00 seconds respectively. Compared to traditional 6MWT, E-6MWT required 67.00% less manpower and 50.10% less in time spent. Physiotherapists (n=7) found E-6MWT is convenient to use (mean=5.14; satisfied to very satisfied), requires less manpower and time to complete the test (mean=4.71; rather satisfied to satisfied), has better data management (mean=5.86; satisfied to very satisfied) and is recommended to be used clinically (mean=5.29; satisfied to very satisfied). It is proven that E-6MWT requires less manpower input with higher efficiency and better data management. It is welcomed by the clinical frontline staff.

Keywords: electronic, physiotherapy, six-minute walk test, 6MWT

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Authors: Yasaman Ashrafi, Stephen Kajewski, Annastiina Silvennoinen, Madhav Nepal

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Mega projects either in construction, urban development or energy sectors are one of the key drivers that build the foundation of wealth and modern civilizations in regions and nations. Such projects require economic justification and substantial capital investment, often derived from individual and corporate investors as well as governments. Cost overruns and time delays in these mega projects demands a new approach to more accurately predict project costs and establish realistic financial plans. The significance of this paper is that the cost efficiency of megaprojects will improve and decrease cost overruns. This research will assist Project Managers (PMs) to make timely and appropriate decisions about both cost and outcomes of ongoing projects. This research, therefore, examines the oil and gas industry where most mega projects apply the classic methods of Cost Performance Index (CPI) and Schedule Performance Index (SPI) and rely on project data to forecast cost and time. Because these projects are always overrun in cost and time even at the early phase of the project, the probabilistic methods of Monte Carlo Simulation (MCS) and Bayesian Adaptive Forecasting method were used to predict project cost at completion of projects. The current theoretical and mathematical models which forecast the total expected cost and project completion date, during the execution phase of an ongoing project will be evaluated. Earned Value Management (EVM) method is unable to predict cost at completion of a project accurately due to the lack of enough detailed project information especially in the early phase of the project. During the project execution phase, the Bayesian adaptive forecasting method incorporates predictions into the actual performance data from earned value management and revises pre-project cost estimates, making full use of the available information. The outcome of this research is to improve the accuracy of both cost prediction and final duration. This research will provide a warning method to identify when current project performance deviates from planned performance and crates an unacceptable gap between preliminary planning and actual performance. This warning method will support project managers to take corrective actions on time.

Keywords: cost forecasting, earned value management, project control, project management, risk analysis, simulation

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Authors: Atara Shriki, Ilana Lavy

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Teaching for the first time an online course dealing with the history of mathematics, we were struggling with questions related to the design of a proper learning environment (LE). Thirteen high school mathematics teachers, M.Ed. students, attended the course. The teachers were engaged in independent reading of mathematical texts, a task that is recognized as complex due to the unique characteristics of such texts. In order to support the learning processes and develop skills that are essential for succeeding in learning online (e.g. self-regulated learning skills, meta-cognitive skills, reflective ability, and self-assessment skills), the LE comprised of three components aimed at “scaffolding” the learning: (1) An online "self-feedback" questionnaires that included drill-and-practice questions. Subsequent to responding the questions the online system provided a grade and the teachers were entitled to correct their answers; (2) Open-ended questions aimed at stimulating critical thinking about the mathematical contents; (3) Reflective questionnaires designed to assist the teachers in steering their learning. Using a mixed-method methodology, an inquiry study examined the learning processes, the learners' difficulties in reading the mathematical texts and on the unique contribution of each component of the LE to the ability of teachers to comprehend the mathematical contents, and support the development of their learning skills. The results indicate that the teachers found the online feedback as most helpful in developing self-regulated learning skills and ability to reflect on deficiencies in knowledge. Lacking previous experience in expressing opinion on mathematical ideas, the teachers had troubles in responding open-ended questions; however, they perceived this assignment as nurturing cognitive and meta-cognitive skills. The teachers also attested that the reflective questionnaires were useful for steering the learning. Although in general the teachers found the LE as supportive, most of them indicated the need to strengthen instructor-learners and learners-learners interactions. They suggested to generate an online forum to enable them receive direct feedback from the instructor, share ideas with other learners, and consult with them about solutions. Apparently, within online LE, supporting learning merely with respect to cognitive aspects is not sufficient. Leaners also need an emotional support and sense a social presence.

Keywords: cognitive and meta-cognitive skills, independent reading of mathematical texts, online learning environment, self-regulated learning skills

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Authors: Monika Konieczyńska, Joanna Fajfer, Olga Lipińska

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In Poland works related to the exploration and prospection of unconventional hydrocarbons (natural gas accumulated in the Silurian shale formations) started in 2007, based on the experience of the other countries that have created new possibilities for the use of existing hydrocarbons resources. The highly water-consuming process of hydraulic fracturing is required for the exploitation of shale gas which implies a need to ensure large volume of water available. As a result considerable amount of mining waste is generated, particularly liquid waste, i.e. flowback fluid with variable chemical composition. The chemical composition of the flowback fluid depends on the composition of the fracturing fluid and the chemistry of the fractured geological formations. Typically, flowback fluid is highly salinated, can be enriched in heavy metals, including rare earth elements, naturally occurring radioactive materials and organic compounds. The generated fluids considered as the extractive waste should be properly managed in the recovery or disposal facility. Problematic issue is both high hydration of waste as well as their variable chemical composition. Also the limited capacity of currently operating facilities is a growing problem. Based on the estimates, currently operating facilities will not be sufficient for the need of waste disposal when extraction of unconventional hydrocarbons starts. Further more, the content of metals in flowback fluids including rare earth elements is a considerable incentive to develop technology of metals recovery. Also recycling is a key factor in terms of selection of treatment process, which should provide that the thresholds required for reuse are met. The paper will present the study of the flowback fluids chemical composition, based on samples from hydraulic fracturing processes performed in Poland. The scheme of flowback fluid cleaning and recovering technology will be reviewed along with a discussion of the results and an assessment of environmental impact, including all generated by-products. The presented technology is innovative due to the metal recovery, as well as purified water supply for hydraulic fracturing process, which is significant contribution to reducing water consumption.

Keywords: environmental impact, flowback fluid, management of special waste streams, metals recovery, shale gas

Procedia PDF Downloads 262

Authors: A. Giani

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The current pedagogical culture recognizes an educational scope within the sports practices. It is widely accepted, in the pedagogical culture, that thanks to the acquisition and development of motor skills, it is also possible to exercise abilities that concern the way of facing and managing the difficulties of everyday life. Sport is a peculiar educational environment: the children have the opportunity to discover the possibilities of their body, to correlate with their peers, and to learn how to manage the rules and the relationship with authorities, such as coaches. Educational aspects of the sport concern both non-formal and formal educational environments. Coaches play a critical role in an agonistic sphere: exactly like the competencies developed by the children, coaches have to work on their skills to properly set up the educational scene. Facing these new educational tasks - which are not new per se, but new because they are brought back to awareness - a few questions arise: does the coach have adequate preparation? Is the training of the coach in this specific area appropriate? This contribution aims to explore the issue in depth by focusing on the reality of the Football School. Starting from a possible sense of pedagogical inadequacy detected during a series of meetings with several football clubs in Piedmont (Italy), there have been highlighted some important educational needs within the professional training of sports coaches. It is indeed necessary for the coach to know the processes underlying the educational relationship in order to better understand the centrality of the assessment during the educational intervention and to be able to manage the asymmetry in the coach-athlete relationship. In order to provide a response to these pedagogical needs, a formative plan has been designed to allow both an in-depth study of educational issues and a correct self-evaluation of certain pedagogical skills’ control levels, led by the coach. This plan has been based on particular practices, the Educational Practices of Pre-test (EPP), a specific version of community practices designed for the extracurricular activities. The above-mentioned practices realized through the use of texts meant as pre-tests, promoted a reflection within the group of coaches: they set up real and plausible sports experiences - in particular football, triggering a reflection about the relationship’s object, spaces, and methods. The characteristic aspect of pre-tests is that it is impossible to anticipate the reflection as it is necessarily connected to the personal experience and sensitivity, requiring a strong interest and involvement by participants: situations must be considered by the coaches as possible settings in which they could be found on the field.

Keywords: relational needs, values, responsibility, self-evaluation

Procedia PDF Downloads 119

Authors: Sylwia Sumińska, Łukasz Kapica, Grzegorz Szczepański

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Introduction: Cognitive skills are a crucial part of everyday functioning. Cognitive skills include perception, attention, language, memory, executive functions, and higher cognitive skills. With the aging of societies, there is an increasing percentage of people whose cognitive skills decline. Cognitive skills affect work performance. The appropriate diagnosis of a worker’s cognitive skills reduces the risk of errors and accidents at work which is also important for senior workers. The study aimed to prepare new cognitive tests for adults aged 20-60 and assess the psychometric properties of the tests. The project responds to the need for reliable and accurate methods of assessing cognitive performance. Computer tests were developed to assess psychomotor performance, attention, and working memory. Method: Two hundred eighty people aged 20-60 will participate in the study in 4 age groups. Inclusion criteria for the study were: no subjective cognitive impairment, no history of severe head injuries, chronic diseases, psychiatric and neurological diseases. The research will be conducted from February - to June 2022. Cognitive tests: 1) Measurement of psychomotor performance: Reaction time, Reaction time with selective attention component; 2) Measurement of sustained attention: Visual search (dots), Visual search (numbers); 3) Measurement of working memory: Remembering words, Remembering letters. To assess the validity and the reliability subjects will perform the Vienna Test System, i.e., “Reaction Test” (reaction time), “Signal Detection” (sustained attention), “Corsi Block-Tapping Test” (working memory), and Perception and Attention Test (TUS), Colour Trails Test (CTT), Digit Span – subtest from The Wechsler Adult Intelligence Scale. Eighty people will be invited to a session after three months aimed to assess the consistency over time. Results: Due to ongoing research, the detailed results from 280 people will be shown at the conference separately in each age group. The results of correlation analysis with the Vienna Test System will be demonstrated as well.

Keywords: aging, attention, cognitive skills, cognitive tests, psychomotor performance, working memory

Procedia PDF Downloads 106

Authors: Tanida Julvanichpong

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Exercise has been regarded as a necessary and important aspect to enhance physical performance and psychology health. Body weight statistics of students in junior high school students in Chonburi Province beyond a standard risk of obesity. Promoting exercise among Junior high school students in Chonburi Province, essential knowledge concerning factors influencing exercise is needed. Therefore, this study aims to (1) determine the levels of perceived exercise behavior, exercise behavior in the past, perceived barriers to exercise, perceived benefits of exercise, perceived self-efficacy to exercise, feelings associated with exercise behavior, influence of the family to exercise, influence of friends to exercise, and the perceived influence of the environment on exercise. (2) examine the predicting ability of each of the above factors while including personal factors (sex, educational level) for exercise behavior. Pender’s Health Promotion Model was used as a guide for the study. Sample included 652 students in junior high schools, Chonburi Provience. The samples were selected by Multi-Stage Random Sampling. Data Collection has been done by using self-administered questionnaires. Data were analyzed using descriptive statistics, Pearson’s product moment correlation coefficient, Eta, and stepwise multiple regression analysis. The research results showed that: 1. Perceived benefits of exercise, influence of teacher, influence of environmental, feelings associated with exercise behavior were at a high level. Influence of the family to exercise, exercise behavior, exercise behavior in the past, perceived self-efficacy to exercise and influence of friends were at a moderate level. Perceived barriers to exercise were at a low level. 2. Exercise behavior was positively significant related to perceived benefits of exercise, influence of the family to exercise, exercise behavior in the past, perceived self-efficacy to exercise, influence of friends, influence of teacher, influence of environmental and feelings associated with exercise behavior (p < .01, respectively) and was negatively significant related to educational level and perceived barriers to exercise (p < .01, respectively). Exercise behavior was significant related to sex (Eta = 0.243, p=.000). 3. Exercise behavior in the past, influence of the family to exercise significantly contributed 60.10 percent of the variance to the prediction of exercise behavior in male students (p < .01). Exercise behavior in the past, perceived self-efficacy to exercise, perceived barriers to exercise, and educational level significantly contributed 52.60 percent of the variance to the prediction of exercise behavior in female students (p < .01).

Keywords: predictive factors, exercise behaviors, Junior high school, Chonburi Province

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Authors: Anila Naz, Arusa Lakhani, Kiran Mubeen, Yasmeen Amarsi

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Pakistan's neonatal mortality rate has the highest proportion in the South Asian region and it is higher in the rural areas as compared to the urban areas. Poor resuscitation techniques and lack of basic newborn resuscitation skills in birth attendants, are contributing factors towards neonatal deaths. Based on the significant outcomes of the Helping Baby Breath (HBB) training, a similar training was implemented for Community Midwives (CMWs) in a low resource setting in Gujrat, Pakistan, to improve their knowledge and skills. The training evaluation was conducted and participant feedback was obtained through both qualitative and quantitative methods. The findings of the quantitative assessment of the training evaluation will be published elsewhere. This paper presents the qualitative evaluation of the training. Objective: The objective of the study was to determine the perceptions of HBB trained CMWs about the effectiveness of the HBB training, and the challenges faced in the implementation of HBB skills for newborn resuscitation, at their work settings. The qualitative descriptive design was used in this study. The purposive sampling technique was chosen to recruit midwives and key informants as participants of the training. Interviews were conducted by using a semi-structured interview guide. The study included a total of five interviews: two focus group interviews for CMWs (10 in each group), and three individual interviews of key informants. The content analysis of the qualitative data yielded three themes: the effectiveness of training, challenges, and suggestions. The findings revealed that the HBB training was effective for the CMWs in terms of its usability, regarding improvement in newborn resuscitation knowledge and skills. Moreover, it enhanced confidence and satisfaction in CMWs. However, less volume of patients was a challenge for a few CMWs with regards to practicing their skills. Due to the inadequate number of patients and less opportunities of practice for several CMWs, they required such trainings frequently, in order to maintain their competency. The CMWs also recommended that HBB training should be part of the Midwifery program curriculum. Moreover, similar trainings were also recommended for other healthcare providers working in low resource settings, including doctors and nurses.

Keywords: neonatal resuscitation technique, helping baby breathe, community midwives, training evaluation

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Authors: Tharwat Ibrahim Rushdy, Warda Youssef Mohammed Morsy, Hanaa Ali Ahmed Elfeky

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Background: Intra-aortic balloon pump (IABP) is the first and the most commonly used mechanical circulatory support for patients with acute coronary syndromes and cardiogenic shock. Therefore, critical care nurses not only have to know how to monitor and operate the IABP, but also to provide interventions for preventing possible complications. Aim of the study: To assess nurses' knowledge and practices regarding care of patients connected to IABP at the ICUs of Cairo University Hospitals. Research design: A descriptive exploratory design was utilized. Sample: Convenience samples of 40 nurses were included in the current study. Setting: This study was carried out at the Intensive Care Units of Cairo University Hospitals. Tools of data collection: Three tools were developed, tested for clarity, and feasibility: a- Nurses' personal background sheet, b- IABP nurses' knowledge self-administered questionnaire, and c- IABP Nurses' practice observational checklist. Results: The majority of the studied sample had unsatisfactory knowledge and practice level (88% & 95%) respectively with a mean of 9.45+2.94 and 30.5+8.7, respectively. Unsatisfactory knowledge was found regarding description and physiological effects, nursing care, indications, contraindications, complications, weaning, and removal of IABP in percentage of 95%, 90%, 72.5%, and 57.5%, respectively, with a mean total knowledge score of 9.45 +2.94. In addition, unsatisfactory practice was found regarding about preparation and initiation of IABP therapy, nursing practice during therapy, weaning, and removal of IABP in percentages of (97.5%, 97.5%, and 90%), respectively. Finally, knowledge level was found to differ significantly in relation to gender (t = 2.46 at P ≤ 0.018). However, gender didn't play a role in relation to practice (t = 0.086 at P≤ 0.932). Conclusion: In spite of having vital role in assessment and management of critically ill patients, critical care nurses in the current study had in general unsatisfactory knowledge and practice regarding care of patients connected to IABP. Recommendation: updating knowledge and practice of ICU nurses through carrying out continuing educational programs about IABP; strict observation of nurses' practice when caring for patients connected to IABP and provision of guidance to correct of poor practices and replication of this study on larger probability sample selected from different geographical locations.

Keywords: knowledge, practice, intra-aortic balloon pump (IABP), ICU nurses, intensive care unit (ICU), introduction

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Authors: Aijing Luo, Zirui Xin, Yifeng Yuan

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Background: With the rapid development of the online health community, more and more patients or families are seeking health information on the Internet. Objective: This study aimed to discuss how to fully reveal the health information needs expressed by hypertensive patients in their questions in the online environment. Methods: This study randomly selected 1,000 text records from the question data of hypertensive patients from 2008 to 2018 collected from the website www.haodf.com and constructed a classification system through literature research and content analysis. This paper identified the background characteristics and questioning the intention of each hypertensive patient based on the patient’s question and used co-occurrence network analysis to explore the features of the health information needs of hypertensive patients. Results: The classification system for health information needs of patients with hypertension is composed of 9 parts: 355 kinds of drugs, 395 kinds of symptoms and signs, 545 kinds of tests and examinations , 526 kinds of demographic data, 80 kinds of diseases, 37 kinds of risk factors, 43 kinds of emotions, 6 kinds of lifestyles, 49 kinds of questions. The characteristics of the explored online health information needs of the hypertensive patients include: i)more than 49% of patients describe the features such as drugs, symptoms and signs, tests and examinations, demographic data, diseases, etc. ii) these groups are most concerned about treatment (77.8%), followed by diagnosis (32.3%); iii) 65.8% of hypertensive patients will ask doctors online several questions at the same time. 28.3% of the patients are very concerned about how to adjust the medication, and they will ask other treatment-related questions at the same time, including drug side effects, whether to take drugs, how to treat a disease, etc.; secondly, 17.6% of the patients will consult the doctors online about the causes of the clinical findings, including the relationship between the clinical findings and a disease, the treatment of a disease, medication, and examinations. Conclusion: In the online environment, the health information needs expressed by Chinese hypertensive patients to doctors are personalized; that is, patients with different background features express their questioning intentions to doctors. The classification system constructed in this study can guide health information service providers in the construction of online health resources, to help solve the problem of information asymmetry in communication between doctors and patients.

Keywords: online health community, health information needs, hypertensive patients, doctor-patient communication

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Authors: Faizah Asiri, Mohammed Fathy, Saeed Alghamdi, Nahlah Ayoub, Faisal Asiri

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Background: - The strategies for this study were based on the toxic effect of long-term inhalation of Benzene on hormones and liver enzymes and various parameters related to it. The following databases were searched: benzene, hepatotoxic, benzene metabolism, hormones, testosterone, hemotoxic, and prolonged exposure. A systematic strategy is designed to search the literature that links benzene with the multiplicity and different types of intoxication or the medical abbreviations of diseases relevant to benzene exposure. Evidence suggests that getting rid of inhaled gasoline is by exhalation. Absorbed benzene is metabolized by giving phenolic acid as well as meconic acid, followed by urinary excretion of conjugate sulfates and glucuronides. Materials and Methods :- This work was conducted in the Al-Khadra laboratory in Taif 2020/2021 and aimed to measure some of the possible endocrinal and liver toxicities associated with benzene's long-term exposure in Saudi Arabia at the station workers who are considered the most exposed category to gasoline. One hundred ten station workers were included in this study. They were divided into four patient groups according to the chronic exposure rate to benzene, one control group, and three other groups of exposures. As follows: patient Group 1 (controlled group), patient Group 2 (exposed less than 1y), patient Group 3 (exposed 1-5 y), patient Group 4 (more than 5). Each group is compared with blood sample parameters (ALT, FSH and Testosterone, TSH). Blood samples were drawn from the participants, and statistical tests were performed. Significant change (p≤0.05) was examined compared to the control group. Workers' exposure to benzene led to a significant change in hematological, hormonal, and hepatic factors compared to the control group. Results:- The results obtained a relationship between long-term exposure to benzene and a decrease in the level of testosterone and FSH hormones, including that it poses a toxic risk in the long term (p≤0.05) when compared to the control. We obtained results confirming that there is no significant coloration between years of exposure and TSH level (p≤0.05) when compared to the control. Conclusion:- We conclude that some hormones and liver enzymes are affected by chronic doses of benzene through inhalation after our study was on the group most exposed to benzene, which is gas station workers.

Keywords: toxicities, benzene, hormones, station workers

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Authors: László Schmidt

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“Post hoc ergo propter hoc” means after it, therefore because of it. In other words: If event Y followed event X, then event Y must have been caused by event X. The question of causation has long been a central theme in philosophical thought, and many different theories have been put forward. However, causality is an essentially contested concept (ECC), as it has no universally accepted definition and is used differently in everyday, scientific, and legal thinking. In the field of law, the question of causality arises mainly in the context of establishing legal liability: in criminal law and in the rules of civil law on liability for damages arising either from breach of contract or from tort. In the study some philosophical theories of causality will be presented and how these theories correlate with legal causality. It’s quite interesting when philosophical abstractions meet the pragmatic demands of jurisprudence. In Hungarian criminal judicial practice the principle of equivalence of conditions is the generally accepted and applicable standard of causation, where all necessary conditions are considered equivalent and thus a cause. The idea is that without the trigger, the subsequent outcome would not have occurred; all the conditions that led to the subsequent outcome are equivalent. In the case where the trigger that led to the result is accompanied by an additional intervening cause, including an accidental one, independent of the perpetrator, the causal link is not broken, but at most the causal link becomes looser. The importance of the intervening causes in the outcome should be given due weight in the imposition of the sentence. According to court practice if the conduct of the offender sets in motion the causal process which led to the result, it does not exclude his criminal liability and does not interrupt the causal process if other factors, such as the victim's illness, may have contributed to it. The concausa does not break the chain of causation, i.e. the existence of a causal link establish the criminal liability of the offender. Courts also adjudicates that if an act is a cause of the result if the act cannot be omitted without the result being omitted. This essentially assumes a hypothetical elimination procedure, i.e. the act must be omitted in thought and then examined to see whether the result would still occur or whether it would be omitted. On the substantive side, the essential condition for establishing the offence is that the result must be demonstrably connected with the activity committed. The provision on the assessment of the facts beyond reasonable doubt must also apply to the causal link: that is to say, the uncertainty of the causal link between the conduct and the result of the offence precludes the perpetrator from being held liable for the result. Sometimes, however, the courts do not specify in the reasons for their judgments what standard of causation they apply, i.e. on what basis they establish the existence of (legal) causation.

Keywords: causation, Hungarian criminal law, responsibility, philosophy of law

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Authors: Nada Mohamed, Abdel Aziz Mohamed

Abstract:

Climate change in coastal areas is a global issue that can be felt on local scale and will be around for decades and centuries to come to an end; it also has critical risks on the city’s economy, communities, and the natural environment. One of these changes that cause a huge risk on coastal cities is the sea level rise (SLR). SLR is a result of scarcity and reduction in global environmental system. The main cause of climate change and global warming is the countries with high development index (HDI) as Japan and Germany while the medium and low HDI countries as Egypt does not have enough awareness and advanced tactics to adapt with this changes that destroy urban areas and cause loss in land and economy. This is why Climate Resilience is one of the UN sustainable development goals 2030, which is calling for actions to strengthen climate change resilience through mitigation and adaptation. For many reasons, adaptation has received less attention than mitigation and it is only recently that adaptation has become a focal global point of attention. This adaption can be achieved through some actions such as upgrading the use and the design of the land, adjusting business and activities of people, and increasing community understanding of climate risks. To reach the adaption goals, and we have to apply a strategic pathway to Climate Resilience, which is the Urban Bioregionalism Paradigm. Resiliency has been framed as persistence, adaptation, and transformation. Climate Resilience decision support system includes a visualization platform where ecological, social, and economic information can be viewed alongside with specific geographies that's why Urban Bioregionalism is a socio-ecological system which is defined as a paradigm that has potential to help move social attitudes toward environmental understanding and deepen human-environment connections within ecological development. The research aim is to achieve an adaptive integrated urban development model throughout the analyses of tactics and strategies that can be used to adapt urban areas and coastal communities to the challenges of climate changes especially SLR and also simulation model using advanced technological software for a coastal city corridor to elaborates the suitable strategy to apply.

Keywords: climate resilience, sea level rise, SLR, coastal resilience, adaptive development simulation

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