Search results for: middle age and elderly
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2182

Search results for: middle age and elderly

1132 Women's Use of Maternal Health-Care Services in Hawassa Zuriya Worda: A Qualitative Study of Women's Childbearing Preference Location

Authors: Elin Mordal, Meseret Tsegaye, Hirut Gemeda, Ingeborg Ulvund

Abstract:

Background: Even the rural-urban gap in the provision of skilled care during childbirth has narrowed, developing countries have the highest percentage of maternal deaths. More important than uncovering deficiencies during pregnancy, is preventing situations of risk during childbirth. The aim of this study was to identify factors women in the rural area consider before they decide where to give birth. Methods: This study utilizes a qualitative descriptive design based on individual interviews with 25 women of childbearing age who has given birth at least once, where women who delivered both at home and a health centre were included. Data collection took place in rural areas around Hawassa Zuriya Worda in Ethiopia February 2015. To identify conditions associated to where women prefer to give birth a thematic analysis was carried out. Result: Experienced risks regarding child birth were the most common reason for women and their families to seek help from skilled birth attendants. Decision-making and planning were identified as a major factor contributing to where women give birth. The women’s position and responsibilities pointed to the fact that women's role is mainly to take care of children and manage the household, while husbands, mother in laws and the elderly are the family members who take most of the decisions. This includes decision about where women give birth. The infrastructure also influences where women choose to give birth. Conclusion: To further improve childbirth care in Hawassa Zuriya Worda it’s important that women get positive experiences, and are met in a safe and supportive way at Health Centers. Challenges appear to women’s autonomy, quality aspects, and infrastructure.

Keywords: childbirth, women, health care utilization, Hawassa Zuriya Worda, Ethiopia, rural area

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1131 Complementary and Traditional Medicine in Turkey

Authors: Hüseyin Biçer

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The purpose of this study is an explanation of using and expectation traditional and complementary medicine in Turkey in terms of regionally, cultural and social. Due to geopolitics position, at the intersection of the Middle East, Africa and Europe, Turkey has historically hosted many civilizations and cultures, and hosts many religions at the same time and therefore is very open to intercultural interaction. For this reason, the traditional medicine of Turkey contains traces of many civilizations rather than a traditional medicine of its own. In Turkey, complementary and traditional medicine are used actively. The aim of the study is to measure whether the patients have ever taken traditional medicine as a caretaker or for the supportive treatment of their diseases, and as a result, their expectations. This cross-sectional, paper-based survey study was conducted in 27 state hospitals and 29 family medicine clinics in seven geographical regions of Turkey. Patients who had an appointment in the waiting rooms that day were included. 77.4% of the patients participating in the study stated that they used traditional medicine at least 5 times in their life, 27.6% stated that traditional medicine was sufficient in some diseases, and 36.8% stated that traditional treatment was a part of normal treatment. Both faith and cultural approaches in Turkey always keep traditional medicine close to drugs. Another danger, apart from traditional medicine drugs that can interact with drugs, is that patients find it sufficient to use traditional and complementary medicine alone.

Keywords: complementary medicine, traditional medicine, medicine in Turkey, alternative medicine

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1130 Algorithm Optimization to Sort in Parallel by Decreasing the Number of the Processors in SIMD (Single Instruction Multiple Data) Systems

Authors: Ali Hosseini

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Paralleling is a mechanism to decrease the time necessary to execute the programs. Sorting is one of the important operations to be used in different systems in a way that the proper function of many algorithms and operations depend on sorted data. CRCW_SORT algorithm executes ‘N’ elements sorting in O(1) time on SIMD (Single Instruction Multiple Data) computers with n^2/2-n/2 number of processors. In this article having presented a mechanism by dividing the input string by the hinge element into two less strings the number of the processors to be used in sorting ‘N’ elements in O(1) time has decreased to n^2/8-n/4 in the best state; by this mechanism the best state is when the hinge element is the middle one and the worst state is when it is minimum. The findings from assessing the proposed algorithm by other methods on data collection and number of the processors indicate that the proposed algorithm uses less processors to sort during execution than other methods.

Keywords: CRCW, SIMD (Single Instruction Multiple Data) computers, parallel computers, number of the processors

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1129 Value of Unilateral Spinal Anaesthesia For Hip Fracture Surgery In The Elderly (75 Cases)

Authors: Fedili Benamar, Beloulou Mohamed Lamine, Ouahes Hassane, Ghattas Samir

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Background and aims: While in Western countries, unilateral spinal anesthesia has been widely practiced for a long time, it remains little known in the local anesthesia community, and has not been the object of many studies. However, it is a simple, practical and effective technique. Our objective was to evaluate this practice in emergency anesthesia management in frail patients and to compare it with conventional spinal anesthesia. Methods: This is a prospective, observational, comparative study between hypobaric unilateral and conventional spinal anaesthesia for hip fracture surgery carried out in the operating room of the university military hospital of Staoueli. The work was spread over of 12-month period from 2019 to 2020. The parameters analyzed were hemodynamic variations, vasopressor use, block efficiency, postoperative adverse events, and postoperative morphine consumption. Results: -75 cases (mean age 72±14 years) -Group1= 41 patients (54.6%) divided into (ASA1=14.6% ASA2=60.98% ASA3=24.39%) single shoot spinal anaesthesia -Group2= 34 patients (45.3%) divided into (ASA1=2.9%, ASA2=26.4% ASA3=61.7%, ASA4=8.8%) unilateral hypobaric spinal anesthesia. -Hemodynamic variations were more severe in group 1 (51% hypotension) compared to 30% in group 2 RR=1.69 and odds ratio=2.4 -these variations were more marked in the ASA3 subgroup (group 1=70% hypotension versus group 2=30%) with an RR=2.33 and an odds ratio=5.44 -39% of group 1 required vasoactive drugs (15mg +/- 11) versus 32% of group 2 (8mg+/- 6.49) - no difference in the use of morphine in post-op. Conclusions: Within the limits of the population studied, this work demonstrates the clinical value of unilateral spinal anesthesia in ortho-trauma surgery in the frail patient.

Keywords: spinal anaesthesia, vasopressor, morphine, hypobaric unilateral spinal anesthesia, ropivacaine, hip surgery, eldery, hemodynamic

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1128 Numerical Study of a Butterfly Valve for Vibration Analysis and Reduction

Authors: Malik I. Al-Amayreh, Mohammad I. Kilani, Ahmed S. Al-Salaymeh

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This works presents a Computational Fluid Dynamics (CFD) simulation of a butterfly valve used to control the flow of combustible gas mixture in an industrial process setting. The work uses CFD simulation to analyze the flow characteristics in the vicinity of the valve, including the velocity distributions, streamlines and path lines. Frequency spectrum of the pressure pulsations downstream the valves, and the vortex shedding allow predicting the torque fluctuations acting on the valve shaft and the possibility of generating mechanical vibration and resonance. These fluctuations are due to aerodynamic torque resulting from fluid turbulence and vortex shedding in the valve vicinity. The valve analyzed is located in a pipeline between two opposing 90o elbows, which exposes the valve and the surrounding structure to the turbulence generated upstream and downstream the elbows at either end of the pipe. CFD simulations show that the best location for the valve from a vibration point of view is in the middle of the pipe joining the elbows.

Keywords: butterfly valve vibration analysis, computational fluid dynamics, fluid flow circuit design, fluctuation

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1127 Law and Literature: The Testimony in Pedro Casaldaliga's Poetic

Authors: Eliziane Navarro

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It is intended, in this study, from some poems from the work of the poet and Bishop of São Félix do Araguaia-MT Brazil Dom Pedro Casaldáliga, to analyze his poetics from the perspective of the environmental law. In his work, Casaldáliga made a considerable manifest against the oppression experienced especially by Xavante people inside the constryside of the state of Mato Grosso when some government programs benefited a large number of landowners in instead of that minority as a power and control self-affirmation process. The attention which Casaldáliga dismissed to the cause of indigenous eviction of their land called Maraiwatsede resulted in numerous death threats against the poet who was not silenced in face of the landowners’ grievances. His voice contributed significantly to the process of land returning to the indigenous people. Because of the international pressure, the Italian company AGIP, owner of the land, tried to return it to the hands of the indigenous, unfortunately, in the middle of the process, the land was occupied by politicians and big landowners of the region. Another objective of this research is to check the connection of his testimonial literature with the actual legal context of the state in the 50s and also to analyze his poetry as a complaint that led the cause of the state's indigenous to the Eco 92 discussion in Rio de Janeiro.

Keywords: law and literature, Brazil, indigenous, Pedro Casaldáliga

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1126 Parent-Child Communication: Community Based HIV/AIDS Response Strategy among Young Persons

Authors: Vicent Lwanga

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Issue: Communication between parent and child is important and necessary. Poor parenting and lack of openness and communication between parents and their children contribute to the increasing rate of HIV infection among young persons between the ages of 10-25. The young person, when left on their own are at the risk of misinformation from peers and from other sources. Description: Parent-Child Communication (PCC) was designed as a key component of a community-based HIV and AIDS intervention focused on young persons by Elderly Widows Orphans Family Support Organisation. Findings from the preliminary community-level process indicated that the lack of parent-child communication militates against young persons adopting and maintaining healthier sexual behaviors. An integrated youth strategy consisting of youth Peer Education/Facilitation and PCC was used to bridge this gap. The process involved an interactive parent-child forum, which allowed parents and children to meet and have open and frank discussions on the needs of young persons and the role of parents. This forum addressed all emerging issues from all parties and created better cordiality amongst them. Lessons Learnt: When young people feel unconnected to their parents, family, or home, they may become involved in activities that put their health at risk. Equally, when parents affirm the value of their children through open interaction, children are more likely to develop positive and healthy attitudes about themselves. Creating the opportunity for this interactive forum is paramount in any intervention program focused on young persons. Conclusion: HIV and AIDS-related programmes, especially those focusing on youth, should have PCC as an integral, essential component. Parents should be vehicles for information dissemination and need to be equipped with the capacity and skills to take on the onerous task of talking sexual reproductive health and sexuality with their children and wards.

Keywords: aids, communication, HIV, youth

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1125 Cross-Sectional Study of Critical Parameters on RSET and Decision-Making of At-Risk Groups in Fire Evacuation

Authors: Naser Kazemi Eilaki, Ilona Heldal, Carolyn Ahmer, Bjarne Christian Hagen

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Elderly people and people with disabilities are recognized as at-risk groups when it comes to egress and travel from hazard zone to a safe place. One's disability can negatively influence her or his escape time, and this becomes even more important when people from this target group live alone. While earlier studies have frequently addressed quantitative measurements regarding at-risk groups' physical characteristics (e.g., their speed of travel), this paper considers the influence of at-risk groups’ characteristics on their decision and determining better escape routes. Most of evacuation models are based on mapping people's movement and their behaviour to summation times for common activity types on a timeline. Usually, timeline models estimate required safe egress time (RSET) as a sum of four timespans: detection, alarm, premovement, and movement time, and compare this with the available safe egress time (ASET) to determine what is influencing the margin of safety.This paper presents a cross-sectional study for identifying the most critical items on RSET and people's decision-making and with possibilities to include safety knowledge regarding people with physical or cognitive functional impairments. The result will contribute to increased knowledge on considering at-risk groups and disabilities for designing and developing safe escape routes. The expected results can be an asset to predict the probabilistic behavioural pattern of at-risk groups and necessary components for defining a framework for understanding how stakeholders can consider various disabilities when determining the margin of safety for a safe escape route.

Keywords: fire safety, evacuation, decision-making, at-risk groups

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1124 Bone Marrow Edema Syndrome in the Foot and Ankle

Authors: S. Alireza Mirghasemi, Elly Trepman, Mohammad Saleh Sadeghi, Narges Rahimi Gabaran, Shervin Rashidinia

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Bone marrow edema syndrome (BMES) is an uncommon and self-limited syndrome characterized by atraumatic extremity pain with unknown of etiology. Symptom onset may include sudden or gradual swelling and pain at rest or during activity, usually at night. This syndrome mostly affects middle-aged men and younger women who have pain in the lower extremities. The most common sites involved with BMES, in decreasing order of frequency, are the bones about the hip, knee, ankle, and foot. The diagnosis of BMES is made with magnetic resonance imaging to exclude other causes of bone marrow edema. The correct diagnosis often is delayed because of the low prevalence and nonspecific signs in the foot and ankle. This delay may intensify bone pain and impair patient function and quality of life. The goal of BMES treatment is to relieve pain and shorten disease duration. Treatment options are limited and may include symptomatic treatment, pharmacologic treatment, and surgery.

Keywords: transient osteoporosis, bone marrow edema syndrome, iloprost, bisphosphonates

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1123 Nutrient Foramina in the Shaft of Long Bones of Upper Limb

Authors: Madala Venkateswara Rao

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The major blood supply to the long bones occurs through the nutrient arteries, which enters through the nutrient foramina. This is the study of nutrient Foramina in the shaft of upper limb long bones taken from the department of Anatomy at Narayana medical college nellore. Nutrient foramina play an important role in nutrition and growth of the bones. Most of the nutrient arteries follow the rule, 'to the elbow I go, from the knee I flee' but they are very variable in position. Their number, location, direction & its importance in the growing end of long bones were studied in the long bones of upper limb. The present study has variations in the position & direction of long bones especially in the radius & ulna, as most of the nutrient foramina are found in anterior surface of upper 1/3rd and middle 1/3rd of these bones. The study of nutrient foramina is not only of academic interest but also in medico-legal practice in relation to their position. Careful observation has also been made on the position of nutrient foramina in relation to upper end of long bones. This study also gives importance of length long bones to know the height of an individual. With the knowledge of variations in the nutrient foramen, placement of internal fixation devices can be appropriately done.

Keywords: nutrient artery, nutrient foramina, shaft of long bones, upper limb bones

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1122 Sex Difference of the Incidence of Sudden Cardiac Arrest/Death in Athletes: A Systematic Review and Meta-analysis

Authors: Lingxia Li, Frédéric Schnell, Shuzhe Ding, Solène Le Douairon Lahaye

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Background: The risk of sudden cardiac arret/death (SCA/D) in athletes is controversial. There is a lack of meta-analyses assessing the sex differences in the risk of SCA/D in competitive athletes. Purpose: The aim of the present study was to evaluate sex differences in the incidence of SCA/D in competitive athletes using meta-analyses. Methods: The systematic review was registered in the PROSPERO database (registration ID: CRD42023432022) and was conducted according to the PRISMA guidelines. PubMed, Embase, Scopus, SPORT Discus and Cochrane Library were searched up to July 2023. To avoid systematic bias in data pooling, only studies with data for both sexes were included. Results: From the 18 included studies, 2028 cases of SCA/D were observed (males 1821 (89.79%), females 207 (10.21%)). The age ranges from the adolescents (<26 years) to the elderly (>45 years). The incidence in male athletes was 1.32/100,000 AY (95% CI: [0.90, 1.93]) and in females was 0.26/100,000 AY (95% CI: [0.16, 0.43]), the incidence rate ratio (IRR) was 6.43 (95% CI: [4.22, 9.79]). The subgroup synthesis showed a higher incidence in males than in females in both age groups <25 years and ≤35 years, the IRR was 5.86 (95% CI: [4.69, 7.32]) and 5.79 (95% CI: [4.73, 7.09]), respectively. When considering the events, the IRR was 6.73 (95%CI: [3.06, 14.78]) among studies involving both SCA/D events and 7.16 (95% CI: [4.93, 10.40]) among studies including only cases of SCD. The available clinical evidence showed that cardiac events were most frequently seen in long-distance running races (26, 35.1%), marathon (16, 21.6%) and soccer (10, 13.5%). Coronary artery disease (14, 18.9%), hypertrophic cardiomyopathy (8, 10.8%), and arrhythmogenic right ventricular cardiomyopathy (7, 9.5%) are the most common causes of SCA/D in competitive athletes. Conclusion: The meta-analysis provides evidence of sex differences in the incidence of SCA/D in competitive athletes. The incidence of SCA/D in male athletes was 6 to 7 times higher than in females. Identifying the reasons for this difference may have implications for targeted the prevention of fatal evets in athletes.

Keywords: incidence, sudden cardiac arrest, sudden cardiac death, sex difference, athletes

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1121 Nonlinear Finite Element Analysis of Composite Cantilever Beam with External Prestressing

Authors: R. I. Liban, N. Tayşi

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This paper deals with a nonlinear finite element analysis to examine the behavior up to failure of cantilever composite steel-concrete beams which are prestressed externally. 'Pre-' means stressing the high strength external tendons in the steel beam section before the concrete slab is added. The composite beam contains a concrete slab which is connected together with steel I-beam by means of perfect shear connectors between the concrete slab and the steel beam which is subjected to static loading. A finite element analysis will be done to study the effects of external prestressed tendons on the composite steel-concrete beams by locating the tendons in different locations (profiles). ANSYS version 12.1 computer program is being used to analyze the represented three-dimensional model of the cantilever composite beam. This model gives all these outputs, mainly load-displacement behavior of the cantilever end and in the middle span of the simple support part.

Keywords: composite steel-concrete beams, external prestressing, finite element analysis, ANSYS

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1120 Systolic Blood Pressure and Its Determinants: Study in a Population Attending Pharmacies in a Portuguese Coastal City

Authors: M. J. Reis Lima, J. Oliveira, M. Brito, C. Lemos, A. Mascarenhas, E. Teixeira Lemos

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Hypertension is a common condition causing cardio and cerebrovascular complications. Portugal has one of the highest mortality rates from stroke and a high prevalence of hypertension. Systolic blood pressure (SBP) is an important risk factor for cardiovascular events (myocardial infarction and stroke) and premature mortality, particularly in the elderly population. The present study aims to estimate the prevalence of hypertension in a Portuguese population living in a coastal city and to identify some of its determinants (namely gender, age, the body mass index and physical activity frequency). A total of 91 adults who attended three pharmacies of a coastal city in the center of Portugal, between May and August of 2013 were evaluated. Attendants who reported to have diabetes or taking antihypertensive drugs in the 2 previous weeks were excluded from the study. Sociodemographic factors, BMI, habits of exercise and BP were assessed. Hypertension was defined as blood pressure ≥140/90 mmHg. The majority of the studied population was constituted by women (75.8%), with a mean age of 54.2±1.6 years old, married or living in civil union and that had completed secondary school or had higher education (40%). They presented a mean BMI of 26.2±4.76 Kg/m2. and were sedentary. The mean BP was 127.0±17.77mmHg- 74.69 ± 9.53. In this population, we found 4.3% of people with hypertension and 16.1% with normal high blood pressure. Men exhibit a tendency to present higher systolic blood pressure values than women. Of all the factors considered, SBP values also tended to be higher with age and higher BMI values. Despite the fact that the mean values of SBP did not present values higher than 140 mmHg we must be concerned because the studied population is undiagnosed for hypertension. Our study even with some limitations might be a prelude to the upcoming research about the underlying factors responsible for the occurrence of SBP.

Keywords: hypertension, age, exercise, obesity and gender

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1119 Potentials for Change in the MENA Region: A Socioeconomic Perspective

Authors: Shaira Karishma Sheriff, Zarinah Hamid

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The Arab Spring, which commenced during the end of 2010 and accelerated during 2011, was caused primarily due to poverty, unemployment and a general recession in the Middle East and North African (MENA) region. The core motivation of this revolution could be said to be the need for political, economic and social reforms that the region desires to experience. Though GDP growth has been significant in the region, the income distribution mechanism in MENA countries has been ineffective. This results in low levels of education, substandard health care facilities, unemployment, and poverty. This paper argues that MENA countries have great potential for experiencing socioeconomic development by being less dependent on oil exports and enhancing their services sector through better education which would eventually lead to job creation. Furthermore, the region can encourage better trade and political integration by forming transparent and accountable governments. The notion of Nation-State needs to be addressed and the countries in the region need to look for ways to develop effective supra-national institutions for better political and economic integration that goes beyond geographical borders.

Keywords: political reforms, social reforms, economic development, nation-state, economic integration

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1118 Substitution Effects of Baijiu and Cigarette Consumption on Anti-Corruption Campaigns: Evidence from China

Authors: Xiaohan Gu

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China is perceived as one of the most politically corrupt countries in the world. The 2021 Transparency International Corruption Perceptions Index China (RPC) ranks the country in 66th place out of 180 countries in the Index, where the 180 countries are perceived to have the most corrupt public sector. This paper proposes a theory on the impact of corruption on the consumption of luxury goods. We test the theory and evaluate the effectiveness of China’s anti-corruption campaign in 2012 by conducting a difference-in-differences analysis of product-city-level alcohol and cigarette consumption from 2013 to 2022. We find that the campaign increased sales of middle-end baijiu and cigarettes but decreased sales of luxury baijiu and cigarettes, contrasting with the trend for low-end products. This substitution pattern may be attributable to decreased public spending on luxury goods. This substitution pattern is moderated by officials’ wages and anti-corruption efforts, which supports the theoretical predictions.

Keywords: substitution effect, baijiu, corruption, anti-corruption, chinese political connection

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1117 Folliculitis Decalvans: Update

Authors: Abdullah Alyoussef

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Folliculitis decalvans is a rare inflammatory scalp disorder. This paper gives an update to patient management and treatment modalities. Folliculitis decalvans is classified as primary neutrophilic cicatricial alopecia and predominantly occurs in middle-aged adults. The cause of folliculitis decalvans (FD) remains unknown. Staphylococcus aureus and a deficient host immune response seem to play an important role in the development of this disfiguring scalp disease. Lesions occur mainly in the vertex and occipital area. Clinically, the lesions present with follicular pustules, lack of ostia, diffuse and perifollicular erythema, follicular tufting, and, oftentimes, hemorrhagic crusts and erosions. Histology displays a mainly neutrophilic inflammatory infiltrate in early lesions and additionally lymphocytes and plasma cells in advanced lesions. Treatment is focused on the eradication of S. aureus and anti-inflammatory agents. Although the etiology of FD is unclear, S. aureus is almost always isolated from affected areas, and eradication is an important part of therapeutic management, in combination with systemic and ⁄ or topical anti-inflammatory treatment.

Keywords: cicatricial alopecia, folliculitis decalvans, tufted folliculitis, erosion

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1116 An Examination of the Factors Affecting the Adoption of Cloud Enterprise Resource Planning Systems in Egyptian Companies

Authors: Mayar A. Omar, Ismail Gomaa, Heba Badawy, Hosam Moubarak

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Enterprise resource planning (ERP) is an integrated system that helps companies in managing their resources. There are two types of ERP systems, traditional ERP systems and cloud ERP systems. Cloud ERP systems were introduced after the development of cloud computing technology. This research aims to identify the factors that affect the adoption of cloud ERP in Egyptian companies. Moreover, the aim of our study is to provide guidance to Egyptian companies in the cloud ERP adoption decision and to participate in increasing the number of cloud ERP studies that are conducted in the Middle East and in developing countries. There are many factors influencing the adoption of cloud ERP in Egyptian organizations, which are discussed and explained in the research. Those factors are examined by combining the diffusion of innovation theory (DOI) and technology-organization-environment framework (TOE). Data were collected through a survey that was developed using constructs from the existing studies of cloud computing and cloud ERP technologies and was then modified to fit our research. The analysis of the data was based on structural equation modeling (SEM) using Smart PLS software that was used for the empirical analysis of the research model.

Keywords: cloud computing, cloud ERP systems, DOI, Egypt, SEM, TOE

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1115 The Penetration of Urban Mobility Multi-Modality Enablers in a Vehicle-Dependent City

Authors: Lama Yaseen, Nourah Al-Hosain

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A Multi-modal system in urban mobility is an essential framework for an optimized urban transport network. Many cities are still heavily dependent on vehicle transportation, dominantly using conventional fuel-based cars for daily travel. With the reliance on motorized vehicles in large cities such as Riyadh, the capital city of Saudi Arabia, traffic congestion is eminent, which ultimately results in an increase in road emissions and loss of time. Saudi Arabia plans to undergo a massive transformation in mobility infrastructure and urban greening projects, including introducing public transport and other massive urban greening infrastructures that enable alternative mobility options. This paper uses a Geographic Information System (GIS) approach that analyzes the accessibility of current and planned public transport stations and how they intertwine with massive urban greening projects that may play a role as an enabler of micro-mobility and walk-ability options in the city.

Keywords: urban development, urban mobility, sustainable mobility, Middle East

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1114 Development of Knowledge Discovery Based Interactive Decision Support System on Web Platform for Maternal and Child Health System Strengthening

Authors: Partha Saha, Uttam Kumar Banerjee

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Maternal and Child Healthcare (MCH) has always been regarded as one of the important issues globally. Reduction of maternal and child mortality rates and increase of healthcare service coverage were declared as one of the targets in Millennium Development Goals till 2015 and thereafter as an important component of the Sustainable Development Goals. Over the last decade, worldwide MCH indicators have improved but could not match the expected levels. Progress of both maternal and child mortality rates have been monitored by several researchers. Each of the studies has stated that only less than 26% of low-income and middle income countries (LMICs) were on track to achieve targets as prescribed by MDG4. Average worldwide annual rate of reduction of under-five mortality rate and maternal mortality rate were 2.2% and 1.9% as on 2011 respectively whereas rates should be minimum 4.4% and 5.5% annually to achieve targets. In spite of having proven healthcare interventions for both mothers and children, those could not be scaled up to the required volume due to fragmented health systems, especially in the developing and under-developed countries. In this research, a knowledge discovery based interactive Decision Support System (DSS) has been developed on web platform which would assist healthcare policy makers to develop evidence-based policies. To achieve desirable results in MCH, efficient resource planning is very much required. In maximum LMICs, resources are big constraint. Knowledge, generated through this system, would help healthcare managers to develop strategic resource planning for combatting with issues like huge inequity and less coverage in MCH. This system would help healthcare managers to accomplish following four tasks. Those are a) comprehending region wise conditions of variables related with MCH, b) identifying relationships within variables, c) segmenting regions based on variables status, and d) finding out segment wise key influential variables which have major impact on healthcare indicators. Whole system development process has been divided into three phases. Those were i) identifying contemporary issues related with MCH services and policy making; ii) development of the system; and iii) verification and validation of the system. More than 90 variables under three categories, such as a) educational, social, and economic parameters; b) MCH interventions; and c) health system building blocks have been included into this web-based DSS and five separate modules have been developed under the system. First module has been designed for analysing current healthcare scenario. Second module would help healthcare managers to understand correlations among variables. Third module would reveal frequently-occurring incidents along with different MCH interventions. Fourth module would segment regions based on previously mentioned three categories and in fifth module, segment-wise key influential interventions will be identified. India has been considered as case study area in this research. Data of 601 districts of India has been used for inspecting effectiveness of those developed modules. This system has been developed by importing different statistical and data mining techniques on Web platform. Policy makers would be able to generate different scenarios from the system before drawing any inference, aided by its interactive capability.

Keywords: maternal and child heathcare, decision support systems, data mining techniques, low and middle income countries

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1113 How Do Undergraduates of Ethnic Minorities Perceive Their Sense of Belonging to School? A Mixed Study in China

Authors: Xiao-Fang Wang

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Researchers of educational psychology have proved that students' sense of belonging to school is conducive to their academic achievement, social relations and mental health. However, little attention is paid to undergraduates' sense of belonging, especially, the distinctive student group, i.e., undergraduate students of ethnic minorities. This article utilized a mixed study approach to investigate the perceptions of undergraduates of ethnic minority toward their sense of belonging to school. The findings from qualitative and quantitative data indicate: 1) generally, the sense of belonging to school of ethnic minority undergraduate students was at the middle level. 2) Gender had an important impact on the sense of belonging, and the sense of girls was much larger than boys’. 3) The sense of belonging to school of students who come from city and town was much larger than the one of students who come from the countryside. 4) The category of subjects had significantly effected on the sense of belonging to school, and, the students from social and art science was larger than those from engineer science. The article is concluded with some valuable and relevant suggestions for university' student management activities and teachers' teaching practice.

Keywords: ethnic minority, undergraduate students, sense of belonging, China

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1112 Analysis of the Interests, Conflicts and Power Resources in the Urban Development in the Megacity of Sao Paulo

Authors: A. G. Back

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Urban planning is a relevant tool to address, in a systemic way, several sectoral policies capable of linking the urban agenda with the reduction of socio-environmental risks. The Sao Paulo’s master plan (2014) presents innovations capable of promoting the transition to sustainability in the urban space, with a view to its regulatory instruments related to i) promotion of density in the axes of mass transport involving the mixture of commercial, residential, services, and leisure uses (principles related to the compact city); ii) vulnerabilities reduction based on housing policies including regular sources of funds for social housing and land reservation in urbanized areas; iii) reserve of green areas in the city to create parks and environmental regulations for new buildings focused on reducing the effects of heat island and improving urban drainage. However, its long-term implementation involves distributive conflicts and can undergo changes in different political, economic, and social contexts over time. Thus, the main objective of this paper is to identify and analyze the dynamics of conflicts of interest between social groups in the implementation of Sao Paulo’s urban development policy, particularly in relation to recent attempts at a (re) interpretation of the Master Plan guidelines, in view of the proposals for revision of the urban zoning law. In this sense, we seek to identify the demands, narratives of urban actors, including the real estate market, middle-class neighborhood associations ('not in my backyard' movements), and social housing rights movements. And we seek to analyze the power resources that these actors mobilize to influence the decision-making process, involving five categories: social capital, political access; discursive resource; media, juridical resource. The major findings of this research suggest that the interests and demands of the real estate market do not always prevail in urban regulation. After all, other actors also press for the definition of urban law with interests opposite to those of the real estate market. This is the case of associations of middle-class neighborhoods, which work to protect the characteristics of the locality, acting, in general, to prevent constructive and population densification in neighborhoods well located near the center, in São Paulo. One of the main demands of these “not in my backyard” movements is the delimitation of exclusively residential areas in the central region of the city, which is not only contrary to the interests of the real state market but also contrary to the principles of the compact city. On the other hand, social housing rights movements have also made progress in delimiting special areas of social interest in well-located and valued areas in the city dedicated to building social housing, also contrary to the interests of the real estate market. An urban development that follows the principles of the compact city must take into account the insertion of low-income populations in well-located regions; otherwise, such a development model may continue to push the less favored to the peripheries towards the preservation areas and/or risk areas.

Keywords: interest groups, Sao Paulo, sustainable urban development, urban policies implementation

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1111 Principles of Municipal Sewage Sludge Bioconversion into Biomineral Fertilizer

Authors: K. V. Kalinichenko, G. N. Nikovskaya

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The efficiency of heavy metals removal from sewage sludge in bioleaching with heterotrophic, chemoautotrophic (sulphur-oxidizing) sludge cenoses and chemical leaching (in distilled water, weakly acidic or alkaline medium) was compared. The efficacy of heavy metals removal from sewage sludge varied from 83 % (Zn) up to 14 % (Cr) and followed the order: Zn > Mn > Cu > Ni > Co > Pb > Cr. The advantages of metals bioleaching process at heterotrophic metabolism was shown. A new process for bioconversation of sewage sludge into fertilizer at middle temperature after partial heavy metals removal was developed. This process is based on enhancing vital ability of heterotrophic microorganisms by adding easily metabolized nutrients and synthesis of metabolites by growing sludge cenoses. These metabolites possess the properties of heavy metals extractants and flocculants which provide sludge flocks sedimentation and concentration. The process results in biomineral fertilizer with immobilized sludge bioelements with prolonged action. The fertilizer obtained satisfied the EU limits for the sewage sludge of agricultural utilization. High efficiency of the biomineral fertilizers obtained has been demonstrated in vegetation experiments.

Keywords: fertilizer, heavy metals, leaching, sewage sludge

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1110 In Search for the 'Bilingual Advantage' in Immersion Education

Authors: M. E. Joret, F. Germeys, P. Van de Craen

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Background: Previous studies have shown that ‘full’ bilingualism seems to enhance the executive functions in children, young adults and elderly people. Executive functions refer to a complex cognitive system responsible for self-controlled and planned behavior and seem to predict academic achievement. The present study aimed at investigating whether similar effects could be found in children learning their second language at school in immersion education programs. Methods: In this study, 44 children involved in immersion education for 4 to 5 years were compared to 48 children in traditional schools. All children were between 9 and 11 years old. To assess executive functions, the Simon task was used, a neuropsychological measure assessing executive functions with reaction times and accuracy on congruent and incongruent trials. To control for background measures, all children underwent the Raven’s coloured progressive matrices, to measure non-verbal intelligence and the Echelle de Vocabulaire en Images Peabody (EVIP), assessing verbal intelligence. In addition, a questionnaire was given to the parents to control for other confounding variables, such as socio-economic status (SES), home language, developmental disorders, etc. Results: There were no differences between groups concerning non-verbal intelligence and verbal intelligence. Furthermore, the immersion learners showed overall faster reaction times on both congruent and incongruent trials compared to the traditional learners, but only after 5 years of training, not before. Conclusion: These results show that the cognitive benefits found in ‘full’ bilinguals also appear in children involved in immersion education, but only after a sufficient exposure to the second language. Our results suggest that the amount of second language training needs to be sufficient before these cognitive effects may emerge.

Keywords: bilingualism, executive functions, immersion education, Simon task

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1109 Scenario-Based Analysis of Electric Vehicle Penetration in Road Transportation in Laos

Authors: Bouneua Khamphilavanh, Toshihiko Masui

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The penetration of EV (electric vehicle) technology in Lao road transportation, in this study, was analyzed by using the AIM/CGE [Laos] model. The computable general equilibrium (CGE) model was developed by the Asia-Pacific Integrated Model (AIM) team. In line with the increase of the number of road vehicles, the energy demand in the transport sector has been gradually increased which resulted in a large amount of budget spent for importing fossil fuels during the last decade, and a high carbon dioxide emission from the transport sector, hence the aim of this research is to analyze the impact of EVs penetration on economic and CO₂ emission in short-term, middle-term, and long-term. By the year 2050, the expected gross domestic product (GDP) value, due to Laos will spend more budget for importing the EV, will be gradually lost up to one percent. The cumulative CO₂ emission from 2020 to 2050 in BAU case will be 12,000 GgCO₂eq, and those in the EV mitigation case will be 9,300 GgCO₂eq, which accounting for likely 77% cumulative CO₂ emission reduction in the road transport sector by introducing the EV technology.

Keywords: GDP, CO₂ mitigation, CGE model, EV technology, transport

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1108 The Impact of Technology on Computer Systems and Technology

Authors: Bishoy Abouelsoud Saad Amin

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This paper examines the use of computer and its related health hazard among computer users in South-Western zone of Nigeria. Two hundred and eighteen (218) computer users constituted the population used to evaluate association between posture, extensive computer use and related health hazard. The instruments for the study are a questionnaire on demographics, lifestyle, body features and work ability index while mean rating, standard deviation and t test were used for data analysis. Identified health related hazard include damages to the eyesight, bad posture, arthritis, musculoskeletal disorders, headache, stress and so on. The results showed that factors such as work demand, posture, closeness to computer screen and excessive working hours on computers constitute health hazards in both old and young computer users of various gender. It is therefore recommended that total number of hours spent with computer should be monitored and controlled.

Keywords: computer game, metaphor, middle school students, virtual environments computer auditing, risk, measures to prevent, information management computer-related health hazard, musculoskeletal disorders, computer usage, work ability index

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1107 Red Dawn in the Desert: A World-Systems Analysis of the Maritime Silk Road Initiative

Authors: Toufic Sarieddine

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The current debate on the hegemonic impact of China’s Belt and Road Initiative (BRI) is of two opposing strands: Resilient and absolute US hegemony on the one hand and various models of multipolar hegemony such as bifurcation on the other. Bifurcation theories illustrate an unprecedented division of hegemonic functions between China and the US, whereby Beijing becomes the world’s economic hegemon, leaving Washington the world’s military hegemon and security guarantor. While consensus points to China being the main driver of unipolarity’s rupturing, the debate among bifurcationists is on the location of the first rupture. In this regard, the Middle East and North Africa (MENA) region has seen increasing Chinese foreign direct investment in recent years while that to other regions has declined, ranking it second in 2018 as part of the financing for the Maritime Silk Road Initiative (MSRI). China has also become the top trade partner of 11 states in the MENA region, as well as its top source of machine imports, surpassing the US and achieving an overall trade surplus almost double that of Washington’s. These are among other features outlined in world-systems analysis (WSA) literature which correspond with the emergence of a new hegemon. WSA is further utilized to gauge other facets of China’s increasing involvement in MENA and assess whether bifurcation is unfolding therein. These features of hegemony include the adoption of China’s modi operandi, economic dominance in production, trade, and finance, military capacity, cultural hegemony in ideology, education, and language, and the promotion of a general interest around which to rally potential peripheries (MENA states in this case). China’s modi operandi has seen some adoption with regards to support against the United Nations Convention on the Law of the Sea, oil bonds denominated in the yuan, and financial institutions such as the Shanghai Gold Exchange enjoying increasing Arab patronage. However, recent elections in Qatar, as well as liberal reforms in Saudi Arabia, demonstrate Washington’s stronger normative influence. Meanwhile, Washington’s economic dominance is challenged by China’s sizable machine exports, increasing overall imports, and widening trade surplus, but retains some clout via dominant arms and transport exports, as well as free-trade deals across the region. Militarily, Washington bests Beijing’s arms exports, has a dominant and well-established presence in the region, and successfully blocked Beijing’s attempt to penetrate through the UAE. Culturally, Beijing enjoys higher favorability in Arab public opinion, and its broadcast networks have found some resonance with Arab audiences. In education, the West remains MENA students’ preferred destination. Further, while Mandarin has become increasingly available in schools across MENA, its usage and availability still lag far behind English. Finally, Beijing’s general interest in infrastructure provision and prioritizing economic development over social justice and democracy provides an avenue for increased incorporation between Beijing and the MENA region. The overall analysis shows solid progress towards bifurcation in MENA.

Keywords: belt and road initiative, hegemony, Middle East and North Africa, world-systems analysis

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1106 p210 BCR-ABL1 CML with CMML Clones: A Rare Presentation

Authors: Mona Vijayaran, Gurleen Oberoi, Sanjay Mishra

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Introduction: p190 BCR‐ABL1 in CML is often associated with monocytosis. In the case described here, monocytosis is associated with coexisting p210 BCR‐ABL and CMML clones. Mutation analysis using next‐generation sequence (NGS) in our case showed TET2 and SRSF2 mutations. Aims & Objectives: A 75-year male was evaluated for monocytosis and thrombocytopenia. CBC showed Hb-11.8g/dl, TLC-12,060/cmm, Monocytes-35%, Platelets-39,000/cmm. Materials & Methods: Bone marrow examination showed a hypercellular marrow with myeloid series showing sequential maturation up to neutrophils with 30% monocytes. Immunophenotyping by flow cytometry from bone marrow had 3% blasts. Making chronic myelomonocytic leukemia as the likely diagnosis. NGS for myeloid mutation panel had TET2 (48.9%) and SRSF2 (32.5%) mutations. This report further supported the diagnosis of CMML. To fulfil the WHO diagnostic criteria for CMML, a BCR ABL1 by RQ-PCR was sent. The report came positive for p210 (B3A2, B2A2) Major Transcript (M-BCR) % IS of 38.418. Result: The patient was counselled regarding the unique presentation of the presence of 2 clones- P210 CML and CMML. After discussion with an international faculty with vast experience in CMML. It was decided to start this elderly gentleman on Imatinib 200mg and not on azacytidine, as ASXL1 was not present; hence, his chances of progressing to AML would be less and on the other end, if CML is left untreated then chances of progression to blast phase would always be a possibility. After 3 months on Imatinib his platelet count improved to 80,000 to 90,000/cmm, but his monocytosis persists. His 3rd month BCR-ABL1 IS% is 0.004%. Conclusion: After searching the literature, there were no case reports of a coexisting CML p210 with CMML. This case might be the first case report. p190 BCR ABL1 is often associated with monocytosis. There are few case reports of p210 BCR ABL1 positivity in patients with monocytosis but none with coexisting CMML. This case highlights the need for extensively evaluating patients with monocytosis with next-generation sequencing for myeloid mutation panel and BCR-ABL1 by RT-PCR to correctly diagnose and treat them.

Keywords: CMML, NGS, p190 CML, Imatinib

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1105 Role of Zakat and Awqf in Socioeconomic Development of Pakistan: Exploring the Issues and Challenges

Authors: Marium. K.Makhdoom, Talat Hussain, Syed H. Bukhari

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The motivation behind this paper is to focus the need of Zakat as a monetary framework with a specific end goal and as a social equity instrument and minimization of the level of poverty in society to assess the socioeconomic development. The procedure of the study includes investigating the applied system of Islamic economics to propose an option display so as to contribute fundamentally to the Ummah and serving the countries. This paper closes to be viewed Zakat as one of the best possible strategies to quantify the socioeconomic development, which implies when individuals pay Zakat the socioeconomic development level will be higher and vice versa. The duties of Muslims to pay Zakat to accomplish practical improvement as far as wealth redistribution in the middle of Muslims and in addition overcoming any and all hardships between the rich and the poor in the general public. The paper adds to consider Zakat as an index to gauge economic development, moreover, the part of Zakat as an instrument of social equity and neediness destruction in the public eye. By and large, this includes the installment every year of more than two percent of one's capital after the needs of the family have been met.

Keywords: Zakat, Waqf, economic development, Pakistan, Islamic economics, macroeconomics, microeconomics

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1104 Excavations in the Maadi Area Maadi-West the Stone House

Authors: Mohamed Bekheit Gad Khaleil

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The Maadi was a civilization .It is considered one of the oldest civilizations in the world and an area of prehistoric times, especially the civilization (Nakada 1&2 ) It contains the oldest stone house in the history. Many excavations have been done in this area. This report was prepared under my supervision and in cooperation with the German institute .The stone building was redocumented, photographed and drawn once again . The stone building has been built carefully. The measurements for this building are (8m x 4m).and the depth of this building is 2m underground and an entrance located at the eastern part of the northern wall and it has three huge pits in the middle of the building seem to have contained wooden posts, most probably to support the roof. The use of the building is unclear. Circular impressions in front of the north wall and in the south-eastern part of the floor indicate that much of it was a storehouse for numerous vessels such as unique feature may have not only served for private domestic purposes. Before starting work in any site, instruction must be followed :- 1-Gather as much information about this place as possible . (Historical background - previous excavations - maps - pictures) 2-Writing, recording, describing and documenting 3- Draw a map of the site showing the place’s division system (trenches) 4- Safe ( Workers & The Place )

Keywords: photographing, excavations, documentation, registration

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1103 Wearable Heart Rate Sensor Based on Wireless System for Heart Health Monitoring

Authors: Murtadha Kareem, Oliver Faust

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Wearable biosensor systems can be designed and developed for health monitoring. There is much interest in both scientific and industrial communities established since 2007. Fundamentally, the cost of healthcare has increased dramatically and the world population is aging. That creates the need to harvest technological improvements with small bio-sensing devices, wireless-communication, microelectronics and smart textiles, that leads to non-stop developments of wearable sensor based systems. There has been a significant demand to monitor patient's health status while the patient leaves the hospital in his/her personal environment. To address this need, there are numerous system prototypes which has been launched in the medical market recently, the aim of that is to provide real time information feedback about patient's health status, either to the patient himself/herself or direct to the supervising medical centre station, while being capable to give a notification for the patient in case of possible imminent health threatening conditions. Furthermore, wearable health monitoring systems comprise new techniques to address the problem of managing and monitoring chronic heart diseases for elderly people. Wearable sensor systems for health monitoring include various types of miniature sensors, either wearable or implantable. To be specific, our proposed system able to measure essential physiological parameter, such as heart rate signal which could be transmitted through Bluetooth to the cloud server in order to store, process, analysis and visualise the data acquisition. The acquired measurements are connected through internet of things to a central node, for instance an android smart phone or tablet used for visualising the collected information on application or transmit it to a medical centre.

Keywords: Wearable sensor, Heart rate, Internet of things, Chronic heart disease

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