Search results for: international classification of primary care
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 13007

Search results for: international classification of primary care

11957 Maternal Health Care Mirage: A Study of Maternal Health Care Utilization for Young Married Muslim Women in India

Authors: Saradiya Mukherjee

Abstract:

Background: Indian Muslims, compared to their counterparts in other religions, generally do not fare well on many yardsticks related to socio-economic progress and the same is true with maternal health care utilization. Due to low age at marriage a major percentage of child birth is ascribed to young (15-24 years) Muslim mothers in, which pose serious concerns on the maternal health care of Young Married Muslim women (YMMW). A thorough search of past literature on Muslim women’s health and health care reveals that studies in India have mainly focused on religious differences in fertility levels and contraceptive use while the research on the determinants of maternal health care utilization among Muslim women are lacking in India. Data and Methods: Retrieving data from the National Family Health Survey -3 (2005-06) this study attempts to assess the level of utilization and factors effecting three key maternal health indicators (full ANC, safe delivery and PNC) among YMMW (15-24 years) in India. The key socio-economic and demographic variables taken as independent or predictor variables in the study was guided by existing literature particularly for India. Bi-variate analysis and chi square test was applied and variables which were found to be significant were further included in binary logistic regression. Results: The findings of the study reveal abysmally low levels of utilization for all three indicators i.e. full ANC, safe delivery and PNC of maternal health care included in the study. Mother’s education, mass media exposure, women’s autonomy, birth order, economic status wanted status of child and region of residence were found to be significant variables effecting maternal health care utilization among YMMW. Multivariate analysis reveals that no mass media exposure, lower autonomy, education, poor economic background, higher birth order and unintended pregnancy are some of the reasons behind low maternal health care utilization. Conclusion: Considering the low level of safe maternal health care utilization and its proximate determinants among YMMW the study suggests educating Muslim girls, promoting family planning use, involving media and collaboration between religious leader and health care system could be some important policy level interventions to address the unmet need of maternity services among YMMW.

Keywords: young Muslim women, religion, socio-economic condition, antenatal care, delivery, post natal care

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11956 An Approach for Vocal Register Recognition Based on Spectral Analysis of Singing

Authors: Aleksandra Zysk, Pawel Badura

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Recognizing and controlling vocal registers during singing is a difficult task for beginner vocalist. It requires among others identifying which part of natural resonators is being used when a sound propagates through the body. Thus, an application has been designed allowing for sound recording, automatic vocal register recognition (VRR), and a graphical user interface providing real-time visualization of the signal and recognition results. Six spectral features are determined for each time frame and passed to the support vector machine classifier yielding a binary decision on the head or chest register assignment of the segment. The classification training and testing data have been recorded by ten professional female singers (soprano, aged 19-29) performing sounds for both chest and head register. The classification accuracy exceeded 93% in each of various validation schemes. Apart from a hard two-class clustering, the support vector classifier returns also information on the distance between particular feature vector and the discrimination hyperplane in a feature space. Such an information reflects the level of certainty of the vocal register classification in a fuzzy way. Thus, the designed recognition and training application is able to assess and visualize the continuous trend in singing in a user-friendly graphical mode providing an easy way to control the vocal emission.

Keywords: classification, singing, spectral analysis, vocal emission, vocal register

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11955 An Automated Business Process Management for Smart Medical Records

Authors: K. Malak, A. Nourah, S.Liyakathunisa

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Nowadays, healthcare services are facing many challenges since they are becoming more complex and more needed. Every detail of a patient’s interactions with health care providers is maintained in Electronic Health Records (ECR) and Healthcare information systems (HIS). However, most of the existing systems are often focused on documenting what happens in manual health care process, rather than providing the highest quality patient care. Healthcare business processes and stakeholders can no longer rely on manual processes, to provide better patient care and efficient utilization of resources, Healthcare processes must be automated wherever it is possible. In this research, a detail survey and analysis is performed on the existing health care systems in Saudi Arabia, and an automated smart medical healthcare business process model is proposed. The business process management methods and rules are followed in discovering, collecting information, analysis, redesign, implementation and performance improvement analysis in terms of time and cost. From the simulation results, it is evident that our proposed smart medical records system can improve the quality of the service by reducing the time and cost and increasing efficiency

Keywords: business process management, electronic health records, efficiency, cost, time

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11954 Class-Size and Instructional Materials as Correlates of Pupils Learning and Academic Achievement in Primary School

Authors: Aanuoluwapo Olusola Adesanya, Adesina Joseph

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This paper examined the class-size and instructional materials as correlates of pupils learning and academic achievement in primary school. The population of the study comprised 198 primary school pupils in three selected schools in Ogun State, Nigeria. Data were collected through questionnaire and were analysed with the use of multiple regression and ANOVA to analysed the correlation between class-size, instructional materials (independent variables) and learning achievement (dependent variable). The findings revealed that schools having an average class-size of 30 and below with use of instructional materials obtained better results than schools having more than 30 and above. The main score were higher in the school in schools having 30 and below than schools with 30 and above. It was therefore recommended that government, stakeholders and NGOs should provide more classrooms and supply of adequate instructional materials in all primary schools in the state to cater for small class-size.

Keywords: class-size, instructional materials, learning, academic achievement

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11953 Epidemiological Profile of Hospital Acquired Infections Caused by Acinetobacter baumannii in Intensive Care Unit

Authors: A. Dali-Ali, F. Agag, H. Beldjilali, A. Oukebdane, K. Meddeber, R. Dali-Yahia, N. Midoun

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The ability of Acinetobacter baumannii to develop multiple resistances towards to the majority of antibiotics explains the therapeutic difficulties encountered in severe infections. Furthermore, its persistence in the humid or dry environment promotes cross-contamination in intensive care units. The aim of our study was to describe the epidemiological and bacterial resistance profiles of hospital-acquired infections caused by Acinetobacter baumannii in the intensive care unit of our teaching hospital. During the study period (June 3, 2012 to December 31, 2013), 305 patients having duration of hospitalization equal or more than 48 hours were included in the study. Among these, 36 had developed, at least, one health-care associated infection caused by Acinetobacter baumannii. The rate of infected patients was equal to 11.8% (36/305). The rate of cumulative incidence of hospital-acquired pneumonia was the highest (9.2%) followed by central venous catheter infection (1.3%). Analysis of the various antibiotic resistance profile shows that 93.8% of the strains were resistant to imipenem. The nosocomial infection control committee set up a special program not only to reduce the high rates of incidence of these infections but also to descrease the rate of imipenem resistance.

Keywords: Acinetobacer baumannii, epidemiological profile, hospital acquired infections, intensive care unit

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11952 The Role of Surgery to Remove the Primary Tumor in Patients with Metastatic Breast Cancer

Authors: A. D. Zikiryahodjaev, L. V. Bolotina, A. S. Sukhotko

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Purpose. To evaluate the expediency and timeliness of performance of surgical treatment as a component of multi-therapy treatment of patients with stage IV breast cancers. Materials and Methods. This investigation comparatively analyzed the results of complex treatment with or without surgery in patients with metastatic breast cancer. We analyzed retrospectively treatment experience of 196 patients with generalized breast cancer in the department of oncology and breast reconstructive surgery of P.A. Herzen Moscow Cancer Research Institute from 2000 to 2012. The average age was (58±1,1) years. Invasive ductul carcinoma was verified in128 patients (65,3%), invasive lobular carcinoma-33 (16,8%), complex form - 19 (9,7%). Complex palliative care involving drug and radiation therapies was performed in two patient groups. The first group includes 124 patients who underwent surgical intervention as complex treatment, the second group includes 72 patients with only medical therapy. Standard systemic therapy was given to all patients. Results. Overall, 3-and 5-year survival in fist group was 43,8 and 21%, in second - 15,1 and 9,3% respectively [p=0,00002 log-rank]. Median survival in patients with surgical treatment composed 32 months, in patients with only systemic therapy-21. The factors having influencing an influence on the prognosis and the quality of life outcomes for of patients with generalized breast cancer were are also studied: hormone-dependent tumor, Her2/neu hyper-expression, reproductive function status (age, menopause existence). Conclusion.Removing primary breast tumor in patients with generalized breast cancer improve long-term outcomes. Three- and five-year survival increased by 28,7 and 16,3% respectively, and median survival–for 11 months. These patients may benefit from resection of the breast tumor. One explanation for the effect of this resection is that reducing the tumor load influences metastatic growth.

Keywords: breast cancer, combination therapy, factors of prognosis, primary tumor

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11951 Performance Comparison of Deep Convolutional Neural Networks for Binary Classification of Fine-Grained Leaf Images

Authors: Kamal KC, Zhendong Yin, Dasen Li, Zhilu Wu

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Intra-plant disease classification based on leaf images is a challenging computer vision task due to similarities in texture, color, and shape of leaves with a slight variation of leaf spot; and external environmental changes such as lighting and background noises. Deep convolutional neural network (DCNN) has proven to be an effective tool for binary classification. In this paper, two methods for binary classification of diseased plant leaves using DCNN are presented; model created from scratch and transfer learning. Our main contribution is a thorough evaluation of 4 networks created from scratch and transfer learning of 5 pre-trained models. Training and testing of these models were performed on a plant leaf images dataset belonging to 16 distinct classes, containing a total of 22,265 images from 8 different plants, consisting of a pair of healthy and diseased leaves. We introduce a deep CNN model, Optimized MobileNet. This model with depthwise separable CNN as a building block attained an average test accuracy of 99.77%. We also present a fine-tuning method by introducing the concept of a convolutional block, which is a collection of different deep neural layers. Fine-tuned models proved to be efficient in terms of accuracy and computational cost. Fine-tuned MobileNet achieved an average test accuracy of 99.89% on 8 pairs of [healthy, diseased] leaf ImageSet.

Keywords: deep convolution neural network, depthwise separable convolution, fine-grained classification, MobileNet, plant disease, transfer learning

Procedia PDF Downloads 185
11950 Effects of Health Information Websites on Health Care Facility Visits

Authors: M. Aljumaan, F. Alkhadra, A. Aldajani, M. Alarfaj, A. Alawami, Y. Aljamaan

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Introduction: The internet has been widely available with 18 million users in Saudi Arabia alone. It was shown that 58% of Saudis are using the internet as a source of health-related information which may contribute to overcrowding of the Emergency Room (ER). Not many studies have been conducted to show the effect of online searching for health related information (HRI) and its role in influencing internet users to visit various health care facilities. So the main objective is to determine a correlation between HRI website use and health care facility visits in Saudi Arabia. Methodology: By conducting a cross sectional study and distributing a questionnaire, a total number of 1095 people were included in the study. Demographic data was collected as well as questions including the use of HRI websites, type of websites used, the reason behind the internet search, which health care facility it lead them to visit and whether seeking health information on the internet influenced their attitude towards visiting health care facilities. The survey was distributed using an internet survey applications. The data was then put on an excel sheet and analyzed with the help of a biostatician for making a correlation. Results: We found 91.4% of our population have used the internet for medical information using mainly General medical websites (77.8%), Forums (34.2%), Social Media (21.6%), and government websites (21.6%). We also found that 66.9% have used the internet for medical information to diagnose and treat their medical conditions on their own while 34.7% did so due to the inability to have a close referral and 29.5% due to their lack of time. Searching for health related information online caused 62.5% of people to visit health care facilities. Outpatient clinics were most visited at 77.9% followed by the ER (27.9%). The remaining 37.5% do not visit because using HRI websites reassure them of their condition. Conclusion: In conclusion, there may be a correlation between health information website use and health care facility visits. However, to avoid potentially inaccurate medical information, we believe doctors have an important role in educating their patients and the public on where to obtain the correct information & advertise the sites that are regulated by health care officials.

Keywords: ER visits, health related information, internet, medical websites

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11949 Harmonic Data Preparation for Clustering and Classification

Authors: Ali Asheibi

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The rapid increase in the size of databases required to store power quality monitoring data has demanded new techniques for analysing and understanding the data. One suggested technique to assist in analysis is data mining. Preparing raw data to be ready for data mining exploration take up most of the effort and time spent in the whole data mining process. Clustering is an important technique in data mining and machine learning in which underlying and meaningful groups of data are discovered. Large amounts of harmonic data have been collected from an actual harmonic monitoring system in a distribution system in Australia for three years. This amount of acquired data makes it difficult to identify operational events that significantly impact the harmonics generated on the system. In this paper, harmonic data preparation processes to better understanding of the data have been presented. Underlying classes in this data has then been identified using clustering technique based on the Minimum Message Length (MML) method. The underlying operational information contained within the clusters can be rapidly visualised by the engineers. The C5.0 algorithm was used for classification and interpretation of the generated clusters.

Keywords: data mining, harmonic data, clustering, classification

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11948 The Model Development of Caregiver Skills for the End of Life’s Cancer Patients

Authors: Chaliya Wamaloon, Malee Chaisaena, Nusara Prasertsri

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Informal caregivers providing home-based palliative and end-of-life (EOL) care to people with advanced cancer is needed, however, there has not been develop caregiver skills for the EOL in cancer patients. The aim of this research was to study the model development of caregiver skills for the EOL in cancer patients. Mixed methods research was conducted in 3 phases. All subjects were in Ubon Rathchathani Cancer Hospital including 30 EOL cancer patient caregivers, 30 EOL cancer patients, and 111 health care professionals who provided care for the EOL cancer patients and 30 EOL target participants who had been trained to be cancer patient caregivers. The research tools were questionnaires, semi structured interviews, and caregiver skills questionnaires. Data were analyzed by using percentage, mean, standard deviation, pair t-test, and content analysis. The result from this study showed the model development of caregiver skills for cancer patients consisted of 9 domains skills: 1. monitoring, 2. interpreting, 3. making decisions, 4. taking action, 5. making adjustments, 6. providing hands-on care, 7. accessing resources, 8. working together with the ill patients, and 9. navigating the healthcare system. The model composed of skills development curriculum for cancer patient caregivers, Manual of palliative care for caregivers, diary of health care records for cancer patients, and the evaluation model of development of caregiver skills for EOL cancer patients. The results of the evaluation in the development model of caregiver skills for EOL cancer patients showed that the caregivers were satisfied with the model of development for caregiver skills at a high level. The comparison of the caregiver skills before and after obtaining the development of caregivers skills revealed that it improved at a statistically significant level (p < 0.05).

Keywords: caregiver, caregiver skills, cancer patients, end of life

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11947 International Integration in Innovative Development of Economy

Authors: Tatyana Kolmykova, Elvira Sitnikova

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Globalization is one of the key processes that are shaping the modern world. There are different often quite opposite attitudes toward globalization. However, it is impossible to avoid the effects of international integration, and they should be addressed in the process of formation and development of the national industrial sector.

Keywords: integrated structures, industrial sector, globalization, national

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11946 Geographic Information System (GIS) for Structural Typology of Buildings

Authors: Néstor Iván Rojas, Wilson Medina Sierra

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Managing spatial information is described through a Geographic Information System (GIS), for some neighborhoods in the city of Tunja, in relation to the structural typology of the buildings. The use of GIS provides tools that facilitate the capture, processing, analysis and dissemination of cartographic information, product quality evaluation of the classification of buildings. Allows the development of a method that unifies and standardizes processes information. The project aims to generate a geographic database that is useful to the entities responsible for planning and disaster prevention and care for vulnerable populations, also seeks to be a basis for seismic vulnerability studies that can contribute in a study of urban seismic microzonation. The methodology consists in capturing the plat including road naming, neighborhoods, blocks and buildings, to which were added as attributes, the product of the evaluation of each of the housing data such as the number of inhabitants and classification, year of construction, the predominant structural systems, the type of mezzanine board and state of favorability, the presence of geo-technical problems, the type of cover, the use of each building, damage to structural and non-structural elements . The above data are tabulated in a spreadsheet that includes cadastral number, through which are systematically included in the respective building that also has that attribute. Geo-referenced data base is obtained, from which graphical outputs are generated, producing thematic maps for each evaluated data, which clearly show the spatial distribution of the information obtained. Using GIS offers important advantages for spatial information management and facilitates consultation and update. Usefulness of the project is recognized as a basis for studies on issues of planning and prevention.

Keywords: microzonation, buildings, geo-processing, cadastral number

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11945 Prevalence of Chronic Diseases and Predictors of Mortality in Home Health Care Service: Data From Saudi Arabia

Authors: Walid A. Alkeridy, Arwa Aljasser, Khalid Mohammed Alayed, Saad Alsaad, Amani S. Alqahtani, Claire Ann Lim, Sultan H. Alamri, Doaa Zainhom Mekkawy, Mohammed Al-Sofiani

Abstract:

Introduction: The history of publicly funded Home Health Care (HHC) service in Saudi Arabia dates back to 1991. The first HC program was launched to provide palliative home care services for patients with terminal cancer. Thereafter, more programs launched across Saudi Arabia most remarkably was launching the national program for HHC by the Ministry Of Health (MOH) in 2008. The national HHC MOH program is mainly providing long-term care home care services for over 40,000 Saudi citizens. The scope of the HHC service program provided by the Saudi MOH is quite diverse, ranging from basic nursing care to specialized care programs, e.g., home peritoneal dialysis, home ventilation, home infusion therapy, etc. Objectives: The primary aim of our study is to report the prevalence of chronic conditions among Saudi people receiving long-term HHC services. Secondary aims include identifying the predictors of mortality among individuals receiving long-term HHC services and studying the association between frailty and poor health outcomes among HHC users. Methods: We conducted a retrospective and cross-sectional data collection from participants receiving HHC services at King Saud University Medical City, Riyadh, Saudi Arabia. Data were collected from electronic health records (EHR), patient charts, and interviewing caregivers from the year 2019 to 2022. We assessed functional performance by Katz's activity of daily living and the Bristol Activity of Daily Living Scale (BADLS). A trained health care provider assessed frailty using the Clinical Frailty Scale (CFS). Mortality was assessed by reviewing the death certificates if patients were hospitalized through discharge status ascertainment from EHR. Results: The mean age for deceased individuals in HHC was 78.3 years. Over twenty percent of individuals receiving HHC services were readmitted to the hospital. The following variables were statistically significant between deceased and alive individuals receiving HHC services; clinical frailty scale, the total number of comorbid conditions, and functional performance based on the KATZ activity of daily living scale and the BADLS. We found that the strongest predictors for mortality were pressure ulcers which had an odds ratio of 3.75 and p-value of < 0.0001, and the clinical frailty scale, which had an odds ratio of 1.69 and p-value of 0.002, using multivariate regression analysis. In conclusion, our study found that pressure ulcers and frailty are the strongest predictors of mortality for individuals receiving home health care services. Moreover, we found a high rate of annual readmission for individuals enrolled in HHC, which requires further analysis to understand the possible contributing factors for the increased rate of hospital readmission and develop strategies to address them. Future studies should focus on designing quality improvement projects aimed at improving the quality of life for individuals receiving HHC services, especially those who have pressure ulcers at the end of life.

Keywords: homecare, Saudi, prevalence, chronic

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11944 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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11943 Unravelling the Knot: Towards a Definition of ‘Digital Labor’

Authors: Marta D'Onofrio

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The debate on the digitalization of the economy has raised questions about how both labor and the regulation of work processes are changing due to the introduction of digital technologies in the productive system. Within the literature, the term ‘digital labor’ is commonly used to identify the impact of digitalization on labor. Despite the wide use of this term, it is still not available an unambiguous definition of it, and this could create confusion in the use of terminology and in the attempts of classification. As a consequence, the purpose of this paper is to provide for a definition and to propose a classification of ‘digital labor’, resorting to the theoretical approach of organizational studies.

Keywords: digital labor, digitalization, data-driven algorithms, big data, organizational studies

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11942 Classification of Tropical Semi-Modules

Authors: Wagneur Edouard

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Tropical algebra is the algebra constructed over an idempotent semifield S. We show here that every m-dimensional tropical module M over S with strongly independent basis can be embedded into Sm, and provide an algebraic invariant -the Γ-matrix of M- which characterises the isomorphy class of M. The strong independence condition also yields a significant improvement to the Whitney embedding for tropical torsion modules published earlier We also show that the strong independence of the basis of M is equivalent to the unique representation of elements of M. Numerous examples illustrate our results.

Keywords: classification, idempotent semi-modules, strong independence, tropical algebra

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11941 The Political and Academic Consideration of Unregulated Concept of Rome Statute in Law No. 26 Year 2000 about Indonesia’s Human Right Court

Authors: Muhammad Iqbal Rachman, Mohammad Faisol Soleh

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The Law No. 26 Year 2000 about Indonesia’s Human Right Court became a new legal enforcement frame of human right law in Indonesia. The new spirit based on some international propulsion in order to enforce human right which basic right of everyone that appearance since in fetus. This matters indicated how crucial the arrangement of human right law, considering the role of state on human right enforcement in this context which became main pillar or instrument to accommodate citizen interest. Basically, the adopting of Law No. 26 Year 2000 came from the womb of concept international crimes regulation based on Rome Statute which became the international law instrument in order to legal enforce of international crimes. But in the other side, the enactment Rome Statute concept in Indonesia has facing with political and academics interest which resulted unaccommodating every type of international crimes in Law No. 26 Year 2000. The analyzing of political and academics background became the fundamental point to find out the solutions based on the regulation of Rome Statute concept matters in Indonesia.

Keywords: academic consideration, human right, political consideration, rome statute, unregulated concept

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11940 Regional Analysis of Freight Movement by Vehicle Classification

Authors: Katerina Koliou, Scott Parr, Evangelos Kaisar

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The surface transportation of freight is particularly vulnerable to storm and hurricane disasters, while at the same time, it is the primary transportation mode for delivering medical supplies, fuel, water, and other essential goods. To better plan for commercial vehicles during an evacuation, it is necessary to understand how these vehicles travel during an evacuation and determine if this travel is different from the general public. The research investigation used Florida's statewide continuous-count station traffic volumes, where then compared between years, to identify locations where traffic was moving differently during the evacuation. The data was then used to identify days on which traffic was significantly different between years. While the literature on auto-based evacuations is extensive, the consideration of freight travel is lacking. To better plan for commercial vehicles during an evacuation, it is necessary to understand how these vehicles travel during an evacuation and determine if this travel is different from the general public. The goal of this research was to investigate the movement of vehicles by classification, with an emphasis on freight during two major evacuation events: hurricanes Irma (2017) and Michael (2018). The methodology of the research was divided into three phases: data collection and management, spatial analysis, and temporal comparisons. Data collection and management obtained continuous-co station data from the state of Florida for both 2017 and 2018 by vehicle classification. The data was then processed into a manageable format. The second phase used geographic information systems (GIS) to display where and when traffic varied across the state. The third and final phase was a quantitative investigation into which vehicle classifications were statistically different and on which dates statewide. This phase used a two-sample, two-tailed t-test to compare sensor volume by classification on similar days between years. Overall, increases in freight movement between years prevented a more precise paired analysis. This research sought to identify where and when different classes of vehicles were traveling leading up to hurricane landfall and post-storm reentry. Of the more significant findings, the research results showed that commercial-use vehicles may have underutilized rest areas during the evacuation, or perhaps these rest areas were closed. This may suggest that truckers are driving longer distances and possibly longer hours before hurricanes. Another significant finding of this research was that changes in traffic patterns for commercial-use vehicles occurred earlier and lasted longer than changes for personal-use vehicles. This finding suggests that commercial vehicles are perhaps evacuating in a fashion different from personal use vehicles. This paper may serve as the foundation for future research into commercial travel during evacuations and explore additional factors that may influence freight movements during evacuations.

Keywords: evacuation, freight, travel time, evacuation

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11939 The Effects of Supportive Care Interventions with Psychotherapeutic and Exercise Approaches on Depressive Symptoms Among Patients with Lung Cancer: A Meta-Analysis

Authors: Chia-Chen Hsieh, Fei-Hsiu Hsiao

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Objective: To examine the effects of supportive care interventions on depressive symptoms in patients with lung cancer. Methods: The databases of Cochrane Central Register of Controlled Trials (CENTRAL), Ovid EMBASE, PubMed, and Chinese Electronic Periodical Services (CEPS) were searched from their inception until September 2015. We included the studies with randomized controlled trial design that compared standard care with supportive care interventions using psychotherapeutic or exercises approach. The standardized mean differences (SMD) (Cohen’s d) were calculated to estimate the treatment effects. The Cochrane Risk of Bias Tool was used for quality assessment and subgroup analysis was conducted to identify possible sources of heterogeneity. Results: A total of 1472 patients with lung cancer were identified. Compared with standard care, the overall effects of all supportive care interventions significantly reduced depressive symptoms (SMD = -0.74 with 95% CI = -1.07 to -0.41), and the effect was maintained at the 4th, 8th, and 12th weeks of follow-up. Either psychotherapy combined with psychoeducation or exercise alone produced significant improvements in depressive symptoms, while psychoeducation alone did not. The greater improvements in depressive symptoms occurred in lung cancer patients with severe depressive symptoms at baseline, total duration of interventions of less than ten weeks, and intervention provided through face-to-face delivery. Conclusions: Psychotherapy combined with psychoeducation can help patients manage the causes of depressive symptoms, including both symptom distress and psychological trauma due to lung cancer. Exercise can target the impaired respiratory function that is a cause of depressive symptoms in lung cancer patients.

Keywords: supportive care intervention, depressive symptoms, lung cancer, meta-analysis

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11938 Classification of Potential Biomarkers in Breast Cancer Using Artificial Intelligence Algorithms and Anthropometric Datasets

Authors: Aref Aasi, Sahar Ebrahimi Bajgani, Erfan Aasi

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Breast cancer (BC) continues to be the most frequent cancer in females and causes the highest number of cancer-related deaths in women worldwide. Inspired by recent advances in studying the relationship between different patient attributes and features and the disease, in this paper, we have tried to investigate the different classification methods for better diagnosis of BC in the early stages. In this regard, datasets from the University Hospital Centre of Coimbra were chosen, and different machine learning (ML)-based and neural network (NN) classifiers have been studied. For this purpose, we have selected favorable features among the nine provided attributes from the clinical dataset by using a random forest algorithm. This dataset consists of both healthy controls and BC patients, and it was noted that glucose, BMI, resistin, and age have the most importance, respectively. Moreover, we have analyzed these features with various ML-based classifier methods, including Decision Tree (DT), K-Nearest Neighbors (KNN), eXtreme Gradient Boosting (XGBoost), Logistic Regression (LR), Naive Bayes (NB), and Support Vector Machine (SVM) along with NN-based Multi-Layer Perceptron (MLP) classifier. The results revealed that among different techniques, the SVM and MLP classifiers have the most accuracy, with amounts of 96% and 92%, respectively. These results divulged that the adopted procedure could be used effectively for the classification of cancer cells, and also it encourages further experimental investigations with more collected data for other types of cancers.

Keywords: breast cancer, diagnosis, machine learning, biomarker classification, neural network

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11937 Engineering Parameters and Classification of Marly Soils of Tabriz

Authors: Amirali Mahouti, Hooshang Katebi

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Enlargement of Tabriz metropolis to the east and north-east caused urban construction to be built on Marl layers and because of increase in excavations depth, further information of this layer is inescapable. Looking at geotechnical investigation shows there is not enough information about Tabriz Marl and this soil has been classified only by color. Tabriz Marl is lacustrine carbonate sediment outcrops, surrounds eastern, northern and southern region of city in the East Azerbaijan Province of Iran and is known as bed rock of city under alluvium sediments. This investigation aims to characterize geotechnical parameters of this soil to identify and set it in classification system of carbonated soils. For this purpose, specimens obtained from 80 locations over the city and subjected to physical and mechanical tests, such as Atterberg limits, density, moisture content, unconfined compression, direct shear and consolidation. CaCO3 content, organic content, PH, XRD, XRF, TGA and geophysical downhole tests also have been done on some of them.

Keywords: carbonated soils, classification of soils, mineralogy, physical and mechanical tests for Marls, Tabriz Marl

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11936 Mothers' Satisfaction with Emergency Care When Their Child Has an Autism Spectrum Disorder

Authors: Merav Ben Natan, Heba Igbarin, Arwa Watted

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Introduction: The rising prevalence of autism spectrum disorders (ASD) has heightened the need to understand the challenges faced by children with ASD and their families in emergency departments (EDs). Children with ASD often experience additional health issues and heightened anxiety in the chaotic ED environment, which can impact their care and parental satisfaction. Purpose: This study aimed to examine factors identified by mothers as affecting their satisfaction with the care provided to their children in the ED, among mothers of children with ASD in comparison to mothers of children without ASD. Design and methods: In this correlational quantitative study, 128 Israeli mothers – 59 (46%) mothers of children with ASD and 69 (54%) of children without ASD - completed an online survey based on a Ministry of Health national survey of patient experience. Results: Mothers of children with ASD expressed lower satisfaction with the care provided. The difference was particularly evident concerning waiting times for examination of the child by nurses and physicians in the ED, whether the nurses were attentive and responsive to the mother's questions and concerns, whether the ED staff demonstrated coordination and cooperation with regard to medical care of the child, and whether work in the ED was conducted in an orderly and organized manner. The presence of communication difficulties in children predicted mothers' satisfaction with care. Conclusions: These findings suggest that certain needs of mothers and/or their children with ASD do not receive an appropriate response in the ED. Practice implications: It is important to raise the awareness of healthcare providers in EDs regarding the needs of children with ASD and their parents, especially children with communication difficulties. Strategies should be implemented to improve the experience of children with ASD and their parents in the ED.

Keywords: autism spectrum disorder, emergency department, parental satisfaction, healthcare challenges

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11935 Using New Machine Algorithms to Classify Iranian Musical Instruments According to Temporal, Spectral and Coefficient Features

Authors: Ronak Khosravi, Mahmood Abbasi Layegh, Siamak Haghipour, Avin Esmaili

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In this paper, a study on classification of musical woodwind instruments using a small set of features selected from a broad range of extracted ones by the sequential forward selection method was carried out. Firstly, we extract 42 features for each record in the music database of 402 sound files belonging to five different groups of Flutes (end blown and internal duct), Single –reed, Double –reed (exposed and capped), Triple reed and Quadruple reed. Then, the sequential forward selection method is adopted to choose the best feature set in order to achieve very high classification accuracy. Two different classification techniques of support vector machines and relevance vector machines have been tested out and an accuracy of up to 96% can be achieved by using 21 time, frequency and coefficient features and relevance vector machine with the Gaussian kernel function.

Keywords: coefficient features, relevance vector machines, spectral features, support vector machines, temporal features

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11934 Primary School Teachers’ Conceptual and Procedural Knowledge of Rational Numbers and Its Effects on Pupils Achievement of Rational Numbers

Authors: Raliatu Mohammed Kashim

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The study investigated primary school teachers conceptual and procedural knowledge of rational numbers to determine how it effects on pupil’s achievement on rational number. Specifically, primary school teachers’ level of conceptual and procedural knowledge about rational number and its effects on their pupils understanding of rational number in primary school was explored. The study was carried out in Bauchi state of Nigeria, Using a multistage design. The first stage was a descriptive design. The second stage involves a pre-test post-test only quasi experiment design. The population of the study comprises of six mathematics teachers holding the Nigerian Certificate in Education (NCE) teaching primary six and their two hundred and ten pupils in intact class. Two instrument namely Conceptual and Procedural knowledge Test (CPKT) and Rational number Achievement Test (RAT) were used for data collection. Data collected was analyzed using ANCOVA and Scheffe’s Test. The result revealed a significant differences between pupils taught by teachers with high conceptual and procedural knowledge and those target by teachers with low conceptual and procedural knowledge.

Keywords: conceptual knowledge, procedural knowledge, rational numbers, multistage design

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11933 Antenatal Factors Associated with Early Onset Neonatal Sepsis among Neonates 0-7 Days at Fort Portal Regional Referral Hospital

Authors: Moses Balina, Archbald Bahizi

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Introduction: Early onset neonatal sepsis is a systemic infection in a newborn baby during the first week after birth and contributes to 50% of neonatal deaths each year. Risk factors for early onset neonatal sepsis, which can be maternal, health care provider, or health care facility associated, can be prevented with access to quality antenatal care. Objective: The objective of the study was to assess early onset neonatal sepsis and antenatal factors associated with Fort Portal Regional Referral Hospital. Methodology: A cross sectional study design was used. The study involved 60 respondents who were mothers of breastfeeding neonates being treated for early onset neonatal sepsis at Fort Portal Regional Referral Hospital neonatal intensive care unit. Simple random sampling was used to select study participants. Data were collected using questionnaires, entered in Stata 16, and analysed using logistic regression. Results: The prevalence of early onset neonatal sepsis at Fort Portal Regional Referral Hospital was 25%. Multivariate analysis revealed that institutional factors were the only antenatal factors found to be significantly associated with early onset neonatal sepsis at Fort Portal Regional Referral Hospital (p < 0.01). Bivariate analysis revealed that attending antenatal care at a health centre III or IV instead of a hospital (p = 0.011) and attending antenatal care in health care facilities with no laboratory investigations (p = 0.048) were risk factors for early onset neonatal sepsis in the newborn at Fort Portal Regional Referral Hospital. Conclusion: Antenatal factors were associated with early onset neonatal sepsis, and health care facility factors like lower level health centre and unavailability of quality laboratory investigations to pregnant women contributed to early onset neonatal sepsis in the newborn. Mentorships, equipping/stocking laboratories, and improving staffing levels were necessary to reduce early onset neonatal sepsis.

Keywords: antenatal factors, early onset neonatal sepsis, neonates 0-7 days, fort portal regional referral hospital

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11932 Rebuilding Health Post-Conflict: Case Studies from Afghanistan, Cambodia, and Mozambique

Authors: Spencer Rutherford, Shadi Saleh

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War and conflict negatively impact all facets of a health system; services cease to function, resources become depleted, and any semblance of governance is lost. Following cessation of conflict, the rebuilding process includes a wide array of international and local actors. During this period, stakeholders must contend with various trade-offs, including balancing sustainable outcomes with immediate health needs, introducing health reform measures while also increasing local capacity, and reconciling external assistance with local legitimacy. Compounding these factors are additional challenges, including coordination amongst stakeholders, the re-occurrence of conflict, and ulterior motives from donors and governments, to name a few. Therefore, the present paper evaluated health system development in three post-conflict countries over a 12-year timeline. Specifically, health policies, health inputs (such infrastructure and human resources), and measures of governance, from the post-conflict periods of Afghanistan, Cambodia, and Mozambique, were assessed against health outputs and other measures. All post-conflict countries experienced similar challenges when rebuilding the health sector, including; division and competition between donors, NGOs, and local institutions; urban and rural health inequalities; and the re-occurrence of conflict. However, countries also employed unique and effective mechanisms for reconstructing their health systems, including; government engagement of the NGO and private sector; integration of competing factions into the same workforce; and collaborative planning for health policy. Based on these findings, best-practice development strategies were determined and compiled into a 12-year framework. Briefly, during the initial stage of the post-conflict period, primary stakeholders should work quickly to draft a national health strategy in collaboration with the government, and focus on managing and coordinating NGOs through performance-based partnership agreements. With this scaffolding in place, the development community can then prioritize the reconstruction of primary health care centers, increasing and retaining health workers, and horizontal integration of immunization services. The final stages should then concentrate on transferring ownership of the health system national institutions, implementing sustainable financing mechanisms, and phasing-out NGO services. Overall, these findings contribute post-conflict health system development by evaluating the process holistically and along a timeline and can be of further use by healthcare managers, policy-makers, and other health professionals.

Keywords: Afghanistan, Cambodia, health system development, health system reconstruction, Mozambique, post-conflict, state-building

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11931 The Effect of Technology on Legal Securities and Privacy Issues

Authors: Nancy Samuel Reyad Farhan

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even though international crook law has grown considerably inside the ultimate decades, it still remains fragmented and lacks doctrinal cohesiveness. Its idea is defined within the doctrine as pretty disputable. there is no concrete definition of the term. in the home doctrine, the hassle of crook law troubles that rise up within the worldwide setting, and international troubles that get up in the national crook regulation, is underdeveloped each theoretically and nearly. To the exceptional of writer’s know-how, there aren't any studies describing worldwide elements of crook law in a complete way, taking a more expansive view of the difficulty. This paper provides consequences of a part of the doctoral studies, assignment a theoretical framework of the worldwide crook law. It ambitions at checking out the present terminology on international components of criminal law. It demonstrates differences among the notions of global crook regulation, criminal regulation international and law worldwide crook. It confronts the belief of crook regulation with associated disciplines and indicates their interplay. It specifies the scope of international criminal regulation. It diagnoses the contemporary criminal framework of global components of criminal regulation, referring to each crook law issues that rise up inside the international setting, and international problems that rise up within the context of national criminal law. ultimately, de lege lata postulates had been formulated and route of modifications in global criminal law turned into proposed. The followed studies hypothesis assumed that the belief of international criminal regulation became inconsistent, not understood uniformly, and there has been no conformity as to its location inside the system of regulation, objective and subjective scopes, while the domestic doctrine did not correspond with international requirements and differed from the global doctrine. applied research strategies covered inter alia a dogmatic and legal technique, an analytical technique, a comparative approach, in addition to desk studies.

Keywords: social networks privacy issues, social networks security issues, social networks privacy precautions measures, social networks security precautions measures

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11930 Stabilization of Clay Soil Using A-3 Soil

Authors: Mohammed Mustapha Alhaji, Sadiku Salawu

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A clay soil which classified under A-7-6 soil according to AASHTO soil classification system and CH according to the unified soil classification system was stabilized using A-3 soil (AASHTO soil classification system). The clay soil was replaced with 0%, 10%, 20% to 100% A-3 soil, compacted at both the BSL and BSH compaction energy level and using unconfined compressive strength as evaluation criteria. The MDD of the compactions at both the BSL and BSH compaction energy levels showed increase in MDD from 0% A-3 soil replacement to 40% A-3 soil replacement after which the values reduced to 100% A-3 soil replacement. The trend of the OMC with varied A-3 soil replacement is similar to that of MDD but in a reversed order. The OMC reduced from 0% A-3 soil replacement to 40% A-3 soil replacement after which the values increased to 100% A-3 soil replacement. This trend was attributed to the observed reduction in the void ratio from 0% A-3 soil replacement to 40% A-3 soil replacement after which the void ratio increased to 100% A-3 soil replacement. The maximum UCS for clay at varied A-3 soil replacement increased from 272 and 770kN/m2 for BSL and BSH compaction energy level at 0% A-3 soil replacement to 295 and 795kN/m2 for BSL and BSH compaction energy level respectively at 10% A-3 soil replacement after which the values reduced to 22 and 60kN/m2 for BSL and BSH compaction energy level respectively at 70% A-3 soil replacement. Beyond 70% A-3 soil replacement, the mixture cannot be moulded for UCS test.

Keywords: A-3 soil, clay minerals, pozzolanic action, stabilization

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11929 Outcomes from a Qualitative Research: Ethnic Prejudice and Identity Difficulties in Experiences of Young People of Foreign Origin Adopted in Italy

Authors: Stefania Lorenzini

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Italy is a country where the phenomenon of international adoption is very considerable: indeed, it is second in the world only to the United States. This contribution deals with issues related to the development of children's identities in international and interethnic adoption. Process of identity construction can be complex in adopted children born and, often, lived for some years of their young life, in geographical, human, social and cultural contexts very different from those they live after adoption. The results of a qualitative research conducted by interviewing young people adopted in Italy make it possible to grasp the different facets of discrimination episodes related to somatic traits, and in particular to the color of the skin, that refer to these young people foreign origin. Outcomes from the research show difficulties in identy construction but also highlight how that evolution of an "intercultural identity" during international and interethnic adoption is possible.

Keywords: discrimination, identity, intercultural education, international adoption

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11928 A Multilevel Analysis of Predictors of Early Antenatal Care Visits among Women of Reproductive Age in Benin: 2017/2018 Benin Demographic and Health Survey

Authors: Ebenezer Kwesi Armah-Ansah, Kenneth Fosu Oteng, Esther Selasi Avinu, Eugene Budu, Edward Kwabena Ameyaw

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Background: Maternal mortality, particularly in Benin, is a major public health concern in Sub-Saharan Africa. To provide a positive pregnancy experience and reduce maternal morbidities, all pregnant women must get appropriate and timely prenatal support. However, many pregnant women in developing countries, including Benin, begin antenatal care late. There is a paucity of empirical literature on the prevalence and predictors of early antenatal care visits in Benin. As a result, the purpose of this study is to investigate the prevalence and predictors of early antenatal care visits among women of productive age in Benin. Methods: This is a secondary analysis of the 2017/2018 Benin Demographic and Health Survey (BDHS) data. The study involved 6,919 eligible women. Data analysis was conducted using Stata version 14.2 for Mac OS. We adopted a multilevel logistic regression to examine the predictors of early ANC visits in Benin. The results were presented as odds ratios (ORs) associated with 95% confidence intervals (CIs) and p-value <0.05 to determine the significant associations. Results: The prevalence of early ANC visits among pregnant women in Benin was 57.03% [95% CI: 55.41-58.64]. In the final multilevel logistic regression, early ANC visit was higher among women aged 30-34 [aOR=1.60, 95% CI=1.17-2.18] compared to those aged 15-19, women with primary education [aOR=1.22, 95% CI=1.06-142] compared to the non-educated women, women who were covered by health insurance [aOR=3.03, 95% CI=1.35-6.76], women without a big problem in getting the money needed for treatment [aOR=1.31, 95% CI=1.16-1.49], distance to the health facility, not a big problem [aOR=1.23, 95% CI=1.08-1.41], and women whose partners had secondary/higher education [aOR=1.35, 95% CI=1.15-1.57] compared with those who were not covered by health insurance, had big problem in getting money needed for treatment, distance to health facility is a big problem and whose partners had no education respectively. However, women who had four or more births [aOR=0.60, 95% CI=0.48-0.74] and those in Atacora Region [aOR=0.50, 95% CI=0.37-0.68] had lower odds of early ANC visit. Conclusion: This study revealed a relatively high prevalence of early ANC visits among women of reproductive age in Benin. Women's age, educational status of women and their partners, parity, health insurance coverage, distance to health facilities, and region were all associated with early ANC visits among women of reproductive in Benin. These factors ought to be taken into account when developing ANC policies and strategies in order to boost early ANC visits among women in Benin. This will significantly reduce maternal and newborn mortality and help achieve the World Health Organization’s recommendation that all pregnant women should initiate early ANC visits within the first three months of pregnancy.

Keywords: antenatal care, Benin, maternal health, pregnancy, DHS, public health

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