Search results for: community based rehabilitation
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 30833

Search results for: community based rehabilitation

19493 Recontextualisation of Political Discourse: A Case Study of Translation of News Stories

Authors: Hossein Sabouri

Abstract:

News stories as one of the branches of political discourse has always been regarded a sensitive and challenging area. Political translators often encounter some struggles that are vitally important when it comes to deal with the political tension between the source culture and the target one. Translating news stories is of prime importance since it has widespread availability and power of defining or even changing the facts. News translation is usually more than straight transfer of source text. Like original text endeavoring to manipulate the readers’ minds with imposing their ideologies, translated text seeking to change these ideologies influenced by ideological power. In other words, translation product is not considered more than a recontextualisation of the source text. The present study examines possible criteria for occurring changes in the translation process of news stories based on the ideological and political stance of translator using theories of ‘critical discourse analysis’and ‘translation and power. Fairclough investigates the ideological issues in (political) discourse and Tymoczko studies the political and power-related engagement of the translator in the process of translation. Incorporation of Fairclough and Gentzler and Tymoczko’s theories paves the way for the researcher to looks at the ideological power position of the translator. Data collection and analysis have been accomplished using 17 political-text samples taken from online news agencies which are related to the ‘Iran’s Nuclear Program’. Based on the findings, recontextualisation is mainly observed in terms of the strategies of ‘substitution, omissions, and addition’ in the translation process. The results of the study suggest that there is a significant relationship between the translation of political texts and ideologies of target culture.

Keywords: news translation, recontextualisation, ideological power, political discourse

Procedia PDF Downloads 176
19492 iCount: An Automated Swine Detection and Production Monitoring System Based on Sobel Filter and Ellipse Fitting Model

Authors: Jocelyn B. Barbosa, Angeli L. Magbaril, Mariel T. Sabanal, John Paul T. Galario, Mikka P. Baldovino

Abstract:

The use of technology has become ubiquitous in different areas of business today. With the advent of digital imaging and database technology, business owners have been motivated to integrate technology to their business operation ranging from small, medium to large enterprises. Technology has been found to have brought many benefits that can make a business grow. Hog or swine raising, for example, is a very popular enterprise in the Philippines, whose challenges in production monitoring can be addressed through technology integration. Swine production monitoring can become a tedious task as the enterprise goes larger. Specifically, problems like delayed and inconsistent reports are most likely to happen if counting of swine per pen of which building is done manually. In this study, we present iCount, which aims to ensure efficient swine detection and counting that hastens the swine production monitoring task. We develop a system that automatically detects and counts swine based on Sobel filter and ellipse fitting model, given the still photos of the group of swine captured in a pen. We improve the Sobel filter detection result through 8-neigbhorhood rule implementation. Ellipse fitting technique is then employed for proper swine detection. Furthermore, the system can generate periodic production reports and can identify the specific consumables to be served to the swine according to schedules. Experiments reveal that our algorithm provides an efficient way for detecting swine, thereby providing a significant amount of accuracy in production monitoring.

Keywords: automatic swine counting, swine detection, swine production monitoring, ellipse fitting model, sobel filter

Procedia PDF Downloads 301
19491 Using Deep Learning for the Detection of Faulty RJ45 Connectors on a Radio Base Station

Authors: Djamel Fawzi Hadj Sadok, Marrone Silvério Melo Dantas Pedro Henrique Dreyer, Gabriel Fonseca Reis de Souza, Daniel Bezerra, Ricardo Souza, Silvia Lins, Judith Kelner

Abstract:

A radio base station (RBS), part of the radio access network, is a particular type of equipment that supports the connection between a wide range of cellular user devices and an operator network access infrastructure. Nowadays, most of the RBS maintenance is carried out manually, resulting in a time consuming and costly task. A suitable candidate for RBS maintenance automation is repairing faulty links between devices caused by missing or unplugged connectors. A suitable candidate for RBS maintenance automation is repairing faulty links between devices caused by missing or unplugged connectors. This paper proposes and compares two deep learning solutions to identify attached RJ45 connectors on network ports. We named connector detection, the solution based on object detection, and connector classification, the one based on object classification. With the connector detection, we get an accuracy of 0:934, mean average precision 0:903. Connector classification, get a maximum accuracy of 0:981 and an AUC of 0:989. Although connector detection was outperformed in this study, this should not be viewed as an overall result as connector detection is more flexible for scenarios where there is no precise information about the environment and the possible devices. At the same time, the connector classification requires that information to be well-defined.

Keywords: radio base station, maintenance, classification, detection, deep learning, automation

Procedia PDF Downloads 180
19490 Green Hospitality Industry: An Experience Study with Game Theory in China

Authors: Min Wei

Abstract:

The green hotel provides the products/services consistent with the full utilization of resources, protecting the ecological environment conducive to customers’ requirements and health. In order to better develop the green hospitality industry, this paper applies the game theory to analyze the intrinsic relationship and balanced interests among the stakeholders including government, hotels, and tourists during green hospitality development. Based on the hypothesis in game theory, this paper tries to construct a linkage mechanism in stakeholders, by which a theoretical basis for the interests’ balance can be realized. By using game theory and constructing a game model including tourists, hotels and government, this paper analyzes the relationship of the various stakeholders involved in the green hospitality development, and subsequently proposes the development model of green hospitality industry. On the one hand, this paper applies game theory to construct a green hotel development model and provides a theoretical basis for the interest balance of stakeholders based on theoretical perspective. On the other hand, the current development of green hospitality industry is still in initial phase, and the outcome of this research tries to guide tourists to form a green awareness and to establish the concept of green consumption for hotel development, so that green hotel products/services are provided. In addition, this paper provides a basis for decision making in the relevant government departments so that the interests of all stakeholders are promoted and cooperative game between stakeholders is established, for which the sustainable development of green hotels is achieved. The findings indicate that the process of achieving green hospitality industry development is to maximize the whole interests of stakeholders.

Keywords: green hospitality, game theory, stakeholders, development model

Procedia PDF Downloads 117
19489 Health Professions Students' Knowledge of and Attitude toward Complementary and Alternative Medicine

Authors: Peter R. Reuter

Abstract:

Health professionals play important roles in helping patients use Complementary and Alternative Medicine (CAM) practices safely and accurately. Consequently, it is important for future health professionals to learn about CAM practices during their time in undergraduate and graduate programs. To satisfy this need for education, teaching CAM in nursing and medical schools and other health professions programs is becoming more prevalent. Our study was the first to look specifically at the knowledge of, and attitude toward CAM of undergraduate health professions students at a university in the U.S. Students were invited to participate in one of two anonymous online surveys depending on whether they were pre-health professions students or graduating health professions seniors. Of the 763 responses analyzed, 71.7% were from pre-health professions students, and 28.3% came from graduating seniors. The overall attitude of participants toward and interest in learning about CAM practices was generally fairly positive with graduating seniors being more positive than pre-health professions students. Yoga, meditation, massage therapy, aromatherapy, and chiropractic care were the practices most respondents had personal experience with. Massage therapy, yoga, chiropractic care, meditation, music therapy, and diet-based therapy received the highest ratings from respondents. Three-quarters of respondents planned on including aspects of holistic medicine in their future career as a health professional. The top five practices named were yoga, meditation, massage therapy, diet-based therapy, and music therapy. The study confirms the need to educate health professions students about CAM practices to give them the background information they need to select or recommend the best practices for their patients' needs.

Keywords: CAM education, health professions, health professions students, pre-health professions students

Procedia PDF Downloads 132
19488 Calcined Tertiaries Hydrotalcites as Supports of Cobalt-Molybdenum Based Catalysts for the Hydrodesulfurization Reaction of Dibenzothiophene

Authors: Edwin Oviedo, Carlos Linares, Philippe Ayrault, Sylvette Brunet

Abstract:

Nowadays, light conventional crude oils are going down. Therefore, the exploitation of heavy crude oils has been increasing. Hence, a major quantity of refractory sulfur compounds such as dibenzothiophene (DBT) should be removed. Many efforts have been carried out to modify hydrotreatment typical supports in order to increase hydrodesulfurization (HDS) reactions. The present work shows the synthesis of tertiaries MgFeAl(0.16), MgFeAl(0.32), CoFeAl, ZnFeAl hydrotalcites, as supports of CoMo based catalysts, where 0.16 and 0.32 are the Fe3+/Al3+ molar ratio. Solids were characterized by different techniques (XRD, CO2-TPD, H2-TPR, FT-IR, BET, Chemical Analysis and HRTEM) and tested in the DBT HDS reaction. The reactions conditions were: Temp=325°C, P=40 Bar, H2/feed=475. Results show that the catalysts CoMo/MgFeAl(0.16) and CoMo/MgFeAl(0.32), which were the most basics, reduced the sulfur content from 500ppm to less than 1 ppm, increasing the cyclohexylbenzene content, i.e. presented a higher selective toward the HYD pathway than reference catalyst CoMo/γ- Al2O3. This is suitable for improving the fuel quality due to the increase of the cetane number. These catalysts were also more active to the HDS reaction increasing the direct desulfurization (DDS) way and presented a good stability. It is advantageous when the gas oil centane number should be improved. Cobalt, iron or zinc species inside support could avoid the Co and Mo dispersion or form spinel species which could be less active to hydrodesulfuration reactions, while hydrotalcites containing Mg increases the HDS activity probably due to improved Co/Mo ratio.

Keywords: catalyst, cetane number, dibenzothiophene, diesel, hydrodesulfurization, hydrotreatment, MoS2

Procedia PDF Downloads 143
19487 Association of Human Immunodeficiency Virus with Incident Autoimmune Hemolytic Anemia: A Population-Based Cohort Study in Taiwan

Authors: Yung-Feng Yen, I-an Jen, Yi-Ming Arthur Chen

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The molecular mimicry between human immunodeficiency virus (HIV) protein and red blood cell (RBC) antigens could induce the production of anti-RBC autoantibodies. However, the association between HIV infection and subsequent development of autoimmune hemolytic anemia (AIHA) remains unclear. This nationwide population-based cohort study aimed to determine the association between incident AIHA and HIV in Taiwan. From 2000–2012, we identified adult people living with HIV/AIDS (PLWHA) from the Taiwan centers for disease control HIV Surveillance System. HIV-infected individuals were defined by positive HIV-1 western blot. Age- and sex-matched controls without HIV infection were selected from the Taiwan National Health Insurance Research Database for comparison. All patients were followed until Dec. 31, 2012, and observed for occurrence of AIHA. Of 171,468 subjects (19,052 PLWHA, 152,416 controls), 30 (0.02%) had incident AIHA during a mean follow-up of 5.45 years, including 23 (0.12%) PLWHA and 7 (0.01%) controls. After adjusting for potential confounders, HIV infection was found to be an independent risk factor of incident AIHA (adjusted hazard ratio [AHR], 20.9; 95% confidence interval [CI], 8.34-52.3). Moreover, PLWHA receiving HAART were more likely to develop AIHA than those not receiving HAART (AHR, 10.8; 95% CI, 2.90-40.1). Additionally, the risk of AIHA was significantly increased in those taking efavirenz (AHR, 3.15; 95% CI, 1.18-8.43) or atazanavir (AHR, 6.58; 95% CI, 1.88-22.9) component of the HAART. In conclusion, HIV infection is an independent risk factor for incident AIHA. Clinicians need to be aware of the higher risk of AIHA in PLWHA.

Keywords: autoimmune disease , hemolytic anemia, HIV, highly active antiretroviral treatment

Procedia PDF Downloads 221
19486 Cosmetic Recommendation Approach Using Machine Learning

Authors: Shakila N. Senarath, Dinesh Asanka, Janaka Wijayanayake

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The necessity of cosmetic products is arising to fulfill consumer needs of personality appearance and hygiene. A cosmetic product consists of various chemical ingredients which may help to keep the skin healthy or may lead to damages. Every chemical ingredient in a cosmetic product does not perform on every human. The most appropriate way to select a healthy cosmetic product is to identify the texture of the body first and select the most suitable product with safe ingredients. Therefore, the selection process of cosmetic products is complicated. Consumer surveys have shown most of the time, the selection process of cosmetic products is done in an improper way by consumers. From this study, a content-based system is suggested that recommends cosmetic products for the human factors. To such an extent, the skin type, gender and price range will be considered as human factors. The proposed system will be implemented by using Machine Learning. Consumer skin type, gender and price range will be taken as inputs to the system. The skin type of consumer will be derived by using the Baumann Skin Type Questionnaire, which is a value-based approach that includes several numbers of questions to derive the user’s skin type to one of the 16 skin types according to the Bauman Skin Type indicator (BSTI). Two datasets are collected for further research proceedings. The user data set was collected using a questionnaire given to the public. Those are the user dataset and the cosmetic dataset. Product details are included in the cosmetic dataset, which belongs to 5 different kinds of product categories (Moisturizer, Cleanser, Sun protector, Face Mask, Eye Cream). An alternate approach of TF-IDF (Term Frequency – Inverse Document Frequency) is applied to vectorize cosmetic ingredients in the generic cosmetic products dataset and user-preferred dataset. Using the IF-IPF vectors, each user-preferred products dataset and generic cosmetic products dataset can be represented as sparse vectors. The similarity between each user-preferred product and generic cosmetic product will be calculated using the cosine similarity method. For the recommendation process, a similarity matrix can be used. Higher the similarity, higher the match for consumer. Sorting a user column from similarity matrix in a descending order, the recommended products can be retrieved in ascending order. Even though results return a list of similar products, and since the user information has been gathered, such as gender and the price ranges for product purchasing, further optimization can be done by considering and giving weights for those parameters once after a set of recommended products for a user has been retrieved.

Keywords: content-based filtering, cosmetics, machine learning, recommendation system

Procedia PDF Downloads 121
19485 Chatbots as Language Teaching Tools for L2 English Learners

Authors: Feiying Wu

Abstract:

Chatbots are computer programs that attempt to engage a human in a dialogue, which originated in the 1960s with MIT's Eliza. However, they have become widespread more recently as advances in language technology have produced chatbots with increasing linguistic quality and sophistication, leading to their potential to serve as a tool for Computer-Assisted Language Learning(CALL). The aim of this article is to assess the feasibility of using two chatbots, Mitsuku and CleverBot, as pedagogical tools for learning English as a second language by stimulating L2 learners with distinct English proficiencies. Speaking of the input of stimulated learners, they are measured by AntWordProfiler to match the user's expected vocabulary proficiency. Totally, there are four chat sessions as each chatbot will converse with both beginners and advanced learners. For evaluation, it focuses on chatbots' responses from a linguistic standpoint, encompassing vocabulary and sentence levels. The vocabulary level is determined by the vocabulary range and the reaction to misspelled words. Grammatical accuracy and responsiveness to poorly formed sentences are assessed for the sentence level. In addition, the assessment of this essay sets 25% lexical and grammatical incorrect input to determine chatbots' corrective ability towards different linguistic forms. Based on statistical evidence and illustration of examples, despite the small sample size, neither Mitsuku nor CleverBot is ideal as educational tools based on their performance through word range, grammatical accuracy, topic range, and corrective feedback for incorrect words and sentences, but rather as a conversational tool for beginners of L2 English.

Keywords: chatbots, CALL, L2, corrective feedback

Procedia PDF Downloads 64
19484 Assessment of Age-Friendliness in Rural Areas: An Investigation of Content Validity

Authors: Barbara Erjauz, Juliane Eichhorn

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Background and Purpose: The world´s population is rapidly aging, wherefore the World Health Organization (WHO) is dealing with concepts of Age-Friendly-Communities and criteria to define them. Also in Germany, we can find an aging population and a large amount of seniors is living in rural areas. Those regions are defined by unique social and environmental characteristics, which can enhance or decrease age-friendliness. To identify and work with these characteristics, we are in need of appropriate assessment instruments. To the author’s best knowledge until now, no instrument could be identified as suitable and scientifically proven for the German speaking area. The aim of the study was to identify an assessment instrument to measure the age-friendliness of rural communities and its psychometric testing regarding the content validity. Methods: A literature search was carried out to identify instruments related to concepts of Age-Friendly-Communities. According to the German situation, an instrument was chosen and modified based on a Delphi-study. In this context, the content validity was investigated by calculating the Content Validity Index (CVI). Results: An instrument consisting of 86 items based on WHO indicators and the German situation in rural areas was created. 43 items (50%) had a Content Validity Index for Items (I-CVI) of 1,00, 37 items (43%) had an I-CVI of >0,78 and > 1.00, and 6 items had an I-CVI of >0,78. The value of the Content Validity Index for Scales, averaging calculation method (S-CVI/Ave) for the entire scale was 0,91. Conclusions: The results indicate a good content validity and it can be concluded that the created instrument represents the phenomenon of age-friendliness in rural areas. Nevertheless, further psychometric testing related to reliability, validity and responsiveness is recommended.

Keywords: assessment, age-friendly, rural, psychometric testing

Procedia PDF Downloads 220
19483 Process Assessment Model for Process Capability Determination Based on ISO/IEC 20000-1:2011

Authors: Harvard Najoan, Sarwono Sutikno, Yusep Rosmansyah

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Most enterprises are now using information technology services as their assets to support business objectives. These kinds of services are provided by the internal service provider (inside the enterprise) or external service provider (outside enterprise). To deliver quality information technology services, the service provider (which from now on will be called ‘organization’) either internal or external, must have a standard for service management system. At present, the standard that is recognized as best practice for service management system for the organization is international standard ISO/IEC 20000:2011. The most important part of this international standard is the first part or ISO/IEC 20000-1:2011-Service Management System Requirement, because it contains 22 for organization processes as a requirement to be implemented in an organizational environment in order to build, manage and deliver quality service to the customer. Assessing organization management processes is the first step to implementing ISO/IEC 20000:2011 into the organization management processes. This assessment needs Process Assessment Model (PAM) as an assessment instrument. PAM comprises two parts: Process Reference Model (PRM) and Measurement Framework (MF). PRM is built by transforming the 22 process of ISO/IEC 20000-1:2011 and MF is based on ISO/IEC 33020. This assessment instrument was designed to assess the capability of service management process in Divisi Teknologi dan Sistem Informasi (Information Systems and Technology Division) as an internal organization of PT Pos Indonesia. The result of this assessment model can be proposed to improve the capability of service management system.

Keywords: ISO/IEC 20000-1:2011, ISO/IEC 33020:2015, process assessment, process capability, service management system

Procedia PDF Downloads 449
19482 An Adaptive Back-Propagation Network and Kalman Filter Based Multi-Sensor Fusion Method for Train Location System

Authors: Yu-ding Du, Qi-lian Bao, Nassim Bessaad, Lin Liu

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The Global Navigation Satellite System (GNSS) is regarded as an effective approach for the purpose of replacing the large amount used track-side balises in modern train localization systems. This paper describes a method based on the data fusion of a GNSS receiver sensor and an odometer sensor that can significantly improve the positioning accuracy. A digital track map is needed as another sensor to project two-dimensional GNSS position to one-dimensional along-track distance due to the fact that the train’s position can only be constrained on the track. A model trained by BP neural network is used to estimate the trend positioning error which is related to the specific location and proximate processing of the digital track map. Considering that in some conditions the satellite signal failure will lead to the increase of GNSS positioning error, a detection step for GNSS signal is applied. An adaptive weighted fusion algorithm is presented to reduce the standard deviation of train speed measurement. Finally an Extended Kalman Filter (EKF) is used for the fusion of the projected 1-D GNSS positioning data and the 1-D train speed data to get the estimate position. Experimental results suggest that the proposed method performs well, which can reduce positioning error notably.

Keywords: multi-sensor data fusion, train positioning, GNSS, odometer, digital track map, map matching, BP neural network, adaptive weighted fusion, Kalman filter

Procedia PDF Downloads 235
19481 Applying Biculturalism in Studying Tourism Host Community Cultural Integrity and Individual Member Stress

Authors: Shawn P. Daly

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Communities heavily engaged in the tourism industry discover their values intersect, meld, and conflict with those of visitors. Maintaining cultural integrity in the face of powerful external pressures causes stress among society members. This effect represents a less studied aspect of sustainable tourism. The present paper brings a perspective unique to the tourism literature: biculturalism. The grounded theories, coherent hypotheses, and validated constructs and indicators of biculturalism represent a sound base from which to consider sociocultural issues in sustainable tourism. Five models describe the psychological state of individuals operating at cultural crossroads: assimilation (joining the new culture), acculturation (grasping the new culture but remaining of the original culture), alternation (varying behavior to cultural context), multicultural (maintaining distinct cultures), and fusion (blending cultures). These five processes divide into two units of analysis (individual and society), permitting research questions at levels important for considering sociocultural sustainability. Acculturation modelling has morphed into dual processes of acculturation (new culture adaptation) and enculturation (original culture adaptation). This dichotomy divides sustainability research questions into human impacts from assimilation (acquiring new culture, throwing away original), separation (rejecting new culture, keeping original), integration (acquiring new culture, keeping original), and marginalization (rejecting new culture, throwing away original). Biculturalism is often cast in terms of its emotional, behavioral, and cognitive dimensions. Required cultural adjustments and varying levels of cultural competence lead to physical, psychological, and emotional outcomes, including depression, lowered life satisfaction and self-esteem, headaches, and back pain—or enhanced career success, social skills, and life styles. Numerous studies provide empirical scales and research hypotheses for sustainability research into tourism’s causality and effect on local well-being. One key issue in applying biculturalism to sustainability scholarship concerns identification and specification of the alternative new culture contacting local culture. Evidence exists for tourism industry, universal tourist, and location/event-specific tourist culture. The biculturalism paradigm holds promise for researchers examining evolving cultural identity and integrity in response to mass tourism. In particular, confirmed constructs and scales simplify operationalization of tourism sustainability studies in terms of human impact and adjustment.

Keywords: biculturalism, cultural integrity, psychological and sociocultural adjustment, tourist culture

Procedia PDF Downloads 393
19480 Prediction of Pounding between Two SDOF Systems by Using Link Element Based On Mathematic Relations and Suggestion of New Equation for Impact Damping Ratio

Authors: Seyed M. Khatami, H. Naderpour, R. Vahdani, R. C. Barros

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Many previous studies have been carried out to calculate the impact force and the dissipated energy between two neighboring buildings during seismic excitation, when they collide with each other. Numerical studies are an important part of impact, which several researchers have tried to simulate the impact by using different formulas. Estimation of the impact force and the dissipated energy depends significantly on some parameters of impact. Mass of bodies, stiffness of spring, coefficient of restitution, damping ratio of dashpot and impact velocity are some known and unknown parameters to simulate the impact and measure dissipated energy during collision. Collision is usually shown by force-displacement hysteresis curve. The enclosed area of the hysteresis loop explains the dissipated energy during impact. In this paper, the effect of using different types of impact models is investigated in order to calculate the impact force. To increase the accuracy of impact model and to optimize the results of simulations, a new damping equation is assumed and is validated to get the best results of impact force and dissipated energy, which can show the accuracy of suggested equation of motion in comparison with other formulas. This relation is called "n-m". Based on mathematical relation, an initial value is selected for the mentioned coefficients and kinetic energy loss is calculated. After each simulation, kinetic energy loss and energy dissipation are compared with each other. If they are equal, selected parameters are true and, if not, the constant of parameters are modified and a new analysis is performed. Finally, two unknown parameters are suggested to estimate the impact force and calculate the dissipated energy.

Keywords: impact force, dissipated energy, kinetic energy loss, damping relation

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19479 Developing Telehealth-Focused Advanced Practice Nurse Educational Partnerships

Authors: Shelley Y. Hawkins

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Introduction/Background: As technology has grown exponentially in healthcare, nurse educators must prepare Advanced Practice Registered Nurse (APRN) graduates with the knowledge and skills in information systems/technology to support and improve patient care and health care systems. APRN’s are expected to lead in caring for populations who lack accessibility and availability through the use of technology, specifically telehealth. The capacity to effectively and efficiently use technology in patient care delivery is clearly delineated in the American Association of Colleges of Nursing (AACN) Doctor of Nursing Practice (DNP) and Master of Science in Nursing (MSN) Essentials. However, APRN’s have minimal, or no, exposure to formalized telehealth education and lack necessary technical skills needed to incorporate telehealth into their patient care. APRN’s must successfully master the technology using telehealth/telemedicine, electronic health records, health information technology, and clinical decision support systems to advance health. Furthermore, APRN’s must be prepared to lead the coordination and collaboration with other healthcare providers in their use and application. Aim/Goal/Purpose: The purpose of this presentation is to establish and operationalize telehealth-focused educational partnerships between one University School of Nursing and two health care systems in order to enhance the preparation of APRN NP students for practice, teaching, and/or scholarly endeavors. Methods: The proposed project was initially presented by the project director to selected multidisciplinary stakeholders including leadership, home telehealth personnel, primary care providers, and decision support systems within two major health care systems to garner their support for acceptance and implementation. Concurrently, backing was obtained from key university-affiliated colleagues including the Director of Simulation and Innovative Learning Lab and Coordinator of the Health Care Informatics Program. Technology experts skilled in design and production in web applications and electronic modules were secured from two local based technology companies. Results: Two telehealth-focused APRN Program academic/practice partnerships have been established. Students have opportunities to engage in clinically based telehealth experiences focused on: (1) providing patient care while incorporating various technology with a specific emphasis on telehealth; (2) conducting research and/or evidence-based practice projects in order to further develop the scientific foundation regarding incorporation of telehealth with patient care; and (3) participating in the production of patient-level educational materials related to specific topical areas. Conclusions: Evidence-based APRN student telehealth clinical experiences will assist in preparing graduates who can effectively incorporate telehealth into their clinical practice. Greater access for diverse populations will be available as a result of the telehealth service model as well as better care and better outcomes at lower costs. Furthermore, APRN’s will provide the necessary leadership and coordination through interprofessional practice by transforming health care through new innovative care models using information systems and technology.

Keywords: academic/practice partnerships, advanced practice nursing, nursing education, telehealth

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19478 The Role of the Corporate Social Responsibility in Poverty Reduction

Authors: M. Verde, G. Falzarano

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The paper examines the connection between corporate social responsibility (CSR), capability approach and poverty reduction; in particular, the local employment development (LED) by way of CSR initiatives. The joint action of LED/CSR results in a win-win situation, not only for the enterprises but also for all the stakeholders involved; in this regard, subsidiarity and coordination between national and regional/local authorities are central to a socially-oriented market economy. In the first section, the CSR is analysed on the basis of its social function in the fight against poverty, as a 'capabilities deprivation'. In the central part, the attention is focused on the relationship between CSR and LED; ergo, on the role of the enterprises in fostering capabilities development (the employment). Besides, all the potential solutions are presented, stressing the possible combinations, in the last part. The benchmark is the enterprise as an economic and a social institution: the business should not be combined with profit merely, paying more attention to its sustainable impact and social contribution. In which way could it be possible? The answer is the CSR. The impact of CSR on poverty reduction is still little explored. The companies help to reduce poverty through economic contribution, human rights and social inclusion; hence, the business becomes an 'agent of development' in order to fight against 'inequality'. The starting point is the pyramid of social responsibility, where ethic and philanthropic responsibilities involve programmes and actions aimed at personal development of the individuals, improving human standard of living in all forms, including poverty, when people do not have a choice between different 'life options', ranging from level of education to employment. At this point, CSR comes into play and works on two dimensions: poverty reduction and poverty prevention, by means of a series of initiatives: first of all, job creation and precarious work reduction. Empowerment of the local actors, financial support and combination of top down and bottom up initiatives are some of CSR areas of activity. Several positive effects occur on individual levels of educations, access to capital, individual health status, empowerment of youth and woman, access to social networks and it was observed that these effects depend on the type of CSR strategy. Indeed, CSR programmes should take into account fundamental criteria, such as the transparency, the information about benefits, a coordination unit among institutions and more clear guidelines. In this way, the advantages to the corporate reputation and to the community translate into a better job matching on the labour market, inter alia. It is important to underline that the success depends on the specific measures of the areas in question, by adapting them to the local needs, in light of general principles and index; therefore, the concrete commitment of the all stakeholders involved is decisive in order to achieve the goals. The enterprise would represent a concrete contribution for the pursuit of sustainable development and for the dissemination of a social and well being awareness.

Keywords: capability approach, local employment development, poverty, social inclusion

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19477 Geodesign Application for Bio-Swale Design: A Data-Driven Design Approach for a Case Site in Ottawa Street North in Hamilton, Ontario, Canada

Authors: Adele Pierre, Nadia Amoroso

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Changing climate patterns are resulting in increased in storm severity, challenging traditional methods of managing stormwater runoff. This research compares a system of bioswales to existing curb and gutter infrastructure in a post-industrial streetscape of Hamilton, Ontario. Using the geodesign process, including rule-based set parameters and an integrated approach combining geospatial information with stakeholder input, a section of Ottawa St. North was modelled to show how green infrastructure can ease the burden on aging, combined sewer systems. Qualitative data was gathered from residents of the neighbourhood through field notes, and quantitative geospatial data through GIS and site analysis. Parametric modelling was used to generate multiple design scenarios, each visualizing resulting impacts on stormwater runoff along with their calculations. The selected design scenarios offered both an aesthetically pleasing urban bioswale street-scape system while minimizing and controlling stormwater runoff. Interactive maps, videos and the 3D model were presented for stakeholder comment via ESRI’s (Environmental System Research Institute) web-scene. The results of the study demonstrate powerful tools that can assist landscape architects in designing, collaborating and communicating stormwater strategies.

Keywords: bioswale, geodesign, data-driven and rule-based design, geodesign, GIS, stormwater management

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19476 The Participation of Graduates and Students of Social Work in the Erasmus Program: a Case Study in the Portuguese context – the Polytechnic of Leiria

Authors: Cezarina da Conceição Santinho Maurício, José Duque Vicente

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Established in 1987, the Erasmus Programme is a program for the exchange of higher education students. Its purposes are several. The mobility developed has contributed to the promotion of multiple learning, the internalization the feeling of belonging to a community, and the consolidation of cooperation between entities or universities. It also allows the experience of a European experience, considering multilingualism one of the bases of the European project and vehicle to achieve the union in diversity. The program has progressed and introduced changes Erasmus+ currently offers a wide range of opportunities for higher education, vocational education and training, school education, adult education, youth, and sport. These opportunities are open to students and other stakeholders, such as teachers. Portugal was one of the countries that readily adhered to this program, assuming itself as an instrument of internationalization of polytechnic and university higher education. Students and social work teachers have been involved in this mobility of learning and multicultural interactions. The presence and activation of this program was made possible by Portugal's joining the European Union. This event was reflected in the field of portuguese social work and contributes to its approach to the reality of european social work. Historically, the Portuguese social work has built a close connection with the Latin American world and, in particular, with Brazil. There are several examples that can be identified in the different historical stages. This is the case of the post-revolution period of 1974 and the presence of the reconceptualization movement, the struggle for enrollment in the higher education circuit, the process of winning a bachelor's degree, and postgraduate training (the first doctorates of social work were carried out in Brazilian universities). This influence is also found in the scope of the authors and the theoretical references used. This study examines the participation of graduates and students of social work in the Erasmus program. The following specific goals were outlined: to identify the host countries and universities; to investigate the dimension and type of mobility made, understand the learning and experiences acquired, identify the difficulties felt, capture their perspectives on social work and the contribution of this experience in training. In the methodological field, the option fell on a qualitative methodology, with the application of semi-structured interviews to graduates and students of social work with Erasmus mobility experience. Once the graduates agreed, the interviews were recorded and transcribed, analyzed according to the previously defined analysis categories. The findings emphasize the importance of this experience for students and graduates in informal and formal learning. The authors conclude with recommendations to reinforce this mobility, either at the individual level or as a project built for the group or collective.

Keywords: erasmus programme, graduates and students of social work, participation, social work

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19475 The 4th Critical R: Conceptualising the Development of Resilience as an Addition to the 3 Rs of the Essential Education Curricula

Authors: Akhentoolove Corbin, Leta De Jonge, Charmaine De Jonge

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Introduction: Various writers have promoted the adoption of the 4th R in the education curricula (relationships, respect, reasoning, religion, computing, science, art, conflict management, music) and the 5th R (responsibility). They argue that the traditional 3 Rs are not adequate for the modern environment and the requirements for students to become functional citizens in society. In particular, the developing countries of the anglophone Caribbean (most of which are tiny islands) are susceptible to the dangers and complexities of climate change and global economic volatility. These proposed additions to the 3Rs do have some justification, but this research considers Resilience as even more important and relevant in a world that is faced with the negative prospects of climate change, poverty, discrimination, and economic volatility. It is argued that the foundation for resilient citizens, workers, and workplaces, must be built in the elementary and secondary/middle schools and then through the tertiary level, to achieve an outcome of more resilient students. Government, business, and society require widespread resilience to be capable of ‘bouncing back’ and be more adaptable, transformational, and sustainable. Methodology: The paper utilises a mixed-methods approach incorporating a questionnaire and interviews to determine participants’ opinions on the importance and relevance of resilience in the schools’ curricula and to government, business, and society. The target groups are as follows: educators at all levels, education administrators, members of the business sector, public sector, and 3rd sector. The research specifically targets the anglophone Caribbean developing countries (Barbados, Guyana, Jamaica, Trinidad, St. Lucia, and St Vincent, and the Grenadines). The research utilises SPSS for data analysis. Major Findings: The preliminary findings suggest that the majority of participants support the adoption of resilience as a 4th R in the curricula of the elementary, secondary/middle schools, and tertiary level in the anglophone Caribbean. The final results will allow the researchers to reveal more specific details on any variations among the islands in the sample andto engage in an in-depth discussion of the relevance and importance of resilience as the 4th R. Conclusion: Results seem to suggest that the education system should adopt the 4th R of resilience so that educators working in collaboration with the family and community/village can develop young citizens who are more resilient and capable of manifesting the behaviours and attitudes associated with ‘bouncing back,’ adaptability, transformation, and sustainability. These findings may be useful for education decision-makers and governments in these Caribbean islands, who have the authority and responsibility for the development of education policy, laws, and regulations.

Keywords: education, resilient students, adaptable, transformational, resilient citizens, workplaces, government

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19474 An Investigation into the Use of an Atomistic, Hermeneutic, Holistic Approach in Education Relating to the Architectural Design Process

Authors: N. Pritchard

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Within architectural education, students arrive fore-armed with; their life-experience; knowledge gained from subject-based learning; their brains and more specifically their imaginations. The learning-by-doing that they embark on in studio-based/project-based learning calls for supervision that allows the student to proactively undertake research and experimentation with design solution possibilities. The degree to which this supervision includes direction is subject to debate and differing opinion. It can be argued that if the student is to learn-by-doing, then design decision making within the design process needs to be instigated and owned by the student so that they have the ability to personally reflect on and evaluate those decisions. Within this premise lies the problem that the student's endeavours can become unstructured and unfocused as they work their way into a new and complex activity. A resultant weakness can be that the design activity is compartmented and not holistic or comprehensive, and therefore, the student's reflections are consequently impoverished in terms of providing a positive, informative feedback loop. The construct proffered in this paper is that a supportive 'armature' or 'Heuristic-Framework' can be developed that facilitates a holistic approach and reflective learning. The normal explorations of architectural design comprise: Analysing the site and context, reviewing building precedents, assimilating the briefing information. However, the student can still be compromised by 'not knowing what they need to know'. The long-serving triad 'Firmness, Commodity and Delight' provides a broad-brush framework of considerations to explore and integrate into good design. If this were further atomised in subdivision formed from the disparate aspects of architectural design that need to be considered within the design process, then the student could sieve through the facts more methodically and reflectively in terms of considering their interrelationship conflict and alliances. The words facts and sieve hold the acronym of the aspects that form the Heuristic-Framework: Function, Aesthetics, Context, Tectonics, Spatial, Servicing, Infrastructure, Environmental, Value and Ecological issues. The Heuristic could be used as a Hermeneutic Model with each aspect of design being focused on and considered in abstraction and then considered in its relation to other aspect and the design proposal as a whole. Importantly, the heuristic could be used as a method for gathering information and enhancing the design brief. The more poetic, mysterious, intuitive, unconscious processes should still be able to occur for the student. The Heuristic-Framework should not be seen as comprehensive prescriptive formulaic or inhibiting to the wide exploration of possibilities and solutions within the architectural design process.

Keywords: atomistic, hermeneutic, holistic, approach architectural design studio education

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19473 Evaluation of Prestressed Reinforced Concrete Slab Punching Shear Using Finite Element Method

Authors: Zhi Zhang, Liling Cao, Seyedbabak Momenzadeh, Lisa Davey

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Reinforced concrete (RC) flat slab-column systems are commonly used in residential or office buildings, as the flat slab provides efficient clearance resulting in more stories at a given height than regular reinforced concrete beam-slab system. Punching shear of slab-column joints is a critical component of two-way reinforced concrete flat slab design. The unbalanced moment at the joint is transferred via slab moment and shear forces. ACI 318 provides an equation to evaluate the punching shear under the design load. It is important to note that the design code considers gravity and environmental load when considering the design load combinations, while it does not consider the effect from differential foundation settlement, which may be a governing load condition for the slab design. This paper describes how prestressed reinforced concrete slab punching shear is evaluated based on ACI 318 provisions and finite element analysis. A prestressed reinforced concrete slab under differential settlements is studied using the finite element modeling methodology. The punching shear check equation is explained. The methodology to extract data for punching shear check from the finite element model is described and correlated with the corresponding code provisions. The study indicates that the finite element analysis results should be carefully reviewed and processed in order to perform accurate punching shear evaluation. Conclusions are made based on the case studies to help engineers understand the punching shear behavior in prestressed and non-prestressed reinforced concrete slabs.

Keywords: differential settlement, finite element model, prestressed reinforced concrete slab, punching shear

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19472 Unsupervised Segmentation Technique for Acute Leukemia Cells Using Clustering Algorithms

Authors: N. H. Harun, A. S. Abdul Nasir, M. Y. Mashor, R. Hassan

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Leukaemia is a blood cancer disease that contributes to the increment of mortality rate in Malaysia each year. There are two main categories for leukaemia, which are acute and chronic leukaemia. The production and development of acute leukaemia cells occurs rapidly and uncontrollable. Therefore, if the identification of acute leukaemia cells could be done fast and effectively, proper treatment and medicine could be delivered. Due to the requirement of prompt and accurate diagnosis of leukaemia, the current study has proposed unsupervised pixel segmentation based on clustering algorithm in order to obtain a fully segmented abnormal white blood cell (blast) in acute leukaemia image. In order to obtain the segmented blast, the current study proposed three clustering algorithms which are k-means, fuzzy c-means and moving k-means algorithms have been applied on the saturation component image. Then, median filter and seeded region growing area extraction algorithms have been applied, to smooth the region of segmented blast and to remove the large unwanted regions from the image, respectively. Comparisons among the three clustering algorithms are made in order to measure the performance of each clustering algorithm on segmenting the blast area. Based on the good sensitivity value that has been obtained, the results indicate that moving k-means clustering algorithm has successfully produced the fully segmented blast region in acute leukaemia image. Hence, indicating that the resultant images could be helpful to haematologists for further analysis of acute leukaemia.

Keywords: acute leukaemia images, clustering algorithms, image segmentation, moving k-means

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19471 A Human Centered Design of an Exoskeleton Using Multibody Simulation

Authors: Sebastian Kölbl, Thomas Reitmaier, Mathias Hartmann

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Trial and error approaches to adapt wearable support structures to human physiology are time consuming and elaborate. However, during preliminary design, the focus lies on understanding the interaction between exoskeleton and the human body in terms of forces and moments, namely body mechanics. For the study at hand, a multi-body simulation approach has been enhanced to evaluate actual forces and moments in a human dummy model with and without a digital mock-up of an active exoskeleton. Therefore, different motion data have been gathered and processed to perform a musculosceletal analysis. The motion data are ground reaction forces, electromyography data (EMG) and human motion data recorded with a marker-based motion capture system. Based on the experimental data, the response of the human dummy model has been calibrated. Subsequently, the scalable human dummy model, in conjunction with the motion data, is connected with the exoskeleton structure. The results of the human-machine interaction (HMI) simulation platform are in particular resulting contact forces and human joint forces to compare with admissible values with regard to the human physiology. Furthermore, it provides feedback for the sizing of the exoskeleton structure in terms of resulting interface forces (stress justification) and the effect of its compliance. A stepwise approach for the setup and validation of the modeling strategy is presented and the potential for a more time and cost-effective development of wearable support structures is outlined.

Keywords: assistive devices, ergonomic design, inverse dynamics, inverse kinematics, multibody simulation

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19470 Timetabling for Interconnected LRT Lines: A Package Solution Based on a Real-world Case

Authors: Huazhen Lin, Ruihua Xu, Zhibin Jiang

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In this real-world case, timetabling the LRT network as a whole is rather challenging for the operator: they are supposed to create a timetable to avoid various route conflicts manually while satisfying a given interval and the number of rolling stocks, but the outcome is not satisfying. Therefore, the operator adopts a computerised timetabling tool, the Train Plan Maker (TPM), to cope with this problem. However, with various constraints in the dual-line network, it is still difficult to find an adequate pairing of turnback time, interval and rolling stocks’ number, which requires extra manual intervention. Aiming at current problems, a one-off model for timetabling is presented in this paper to simplify the procedure of timetabling. Before the timetabling procedure starts, this paper presents how the dual-line system with a ring and several branches is turned into a simpler structure. Then, a non-linear programming model is presented in two stages. In the first stage, the model sets a series of constraints aiming to calculate a proper timing for coordinating two lines by adjusting the turnback time at termini. Then, based on the result of the first stage, the model introduces a series of inequality constraints to avoid various route conflicts. With this model, an analysis is conducted to reveal the relation between the ratio of trains in different directions and the possible minimum interval, observing that the more imbalance the ratio is, the less possible to provide frequent service under such strict constraints.

Keywords: light rail transit (LRT), non-linear programming, railway timetabling, timetable coordination

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19469 To Access the Knowledge, Awareness and Factors Associated With Diabetes Mellitus in Buea, Cameroon

Authors: Franck Acho

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This is a chronic metabolic disorder which is a fast-growing global problem with a huge social, health, and economic consequences. It is estimated that in 2010 there were globally 285 million people (approximately 6.4% of the adult population) suffering from this disease. This number is estimated to increase to 430 million in the absence of better control or cure. An ageing population and obesity are two main reasons for the increase. Diabetes mellitus is a chronic heterogeneous metabolic disorder with a complex pathogenesis. It is characterized by elevated blood glucose levels or hyperglycemia, which results from abnormalities in either insulin secretion or insulin action or both. Hyperglycemia manifests in various forms with a varied presentation and results in carbohydrate, fat, and protein metabolic dysfunctions. Long-term hyperglycemia often leads to various microvascular and macrovascular diabetic complications, which are mainly responsible for diabetes-associated morbidity and mortality. Hyperglycemia serves as the primary biomarker for the diagnosis of diabetes as well. Furthermore, it has been shown that almost 50% of the putative diabetics are not diagnosed until 10 years after onset of the disease, hence the real prevalence of global diabetes must be astronomically high. This study was conducted in a locality to access the level of knowledge, awareness and risk factors associated with people leaving with diabetes mellitus. A month before the screening was to be conducted, a health screening in some selected churches and on the local community radio as well as on relevant WhatsApp groups were advertised. A general health talk was delivered by the head of the screening unit to all attendees who were all educated on the procedure to be carried out with benefits and any possible discomforts after which the attendee’s consent was obtained. Evaluation of the participants for any leads to the diabetes selected for the screening was done by taking adequate history and physical examinations such as excessive thirst, increased urination, tiredness, hunger, unexplained weight loss, feeling irritable or having other mood changes, having blurry vision, having slow-healing sores, getting a lot of infections, such as gum, skin and vaginal infections. Out of the 94 participants the finding show that 78 were females and 16 were males, 70.21% of participants with diabetes were between the ages of 60-69yrs.The study found that only 10.63% of respondents declared a good level of knowledge of diabetes. Out of 3 symptoms of diabetes analyzed in this study, high blood sugar (58.5%) and chronic fatigue (36.17%) were the most recognized. Out of 4 diabetes risk factors analyzed in this study, obesity (21.27%) and unhealthy diet (60.63%) were the most recognized diabetes risk factors, while only 10.6% of respondents indicated tobacco use. The diabetic foot was the most recognized diabetes complication (50.57%), but some the participants indicated vision problems (30.8%),or cardiovascular diseases (20.21%) as diabetes complications.

Keywords: diabetes mellitus, non comunicable disease, general health talk, hyperglycemia

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19468 The DAQ Debugger for iFDAQ of the COMPASS Experiment

Authors: Y. Bai, M. Bodlak, V. Frolov, S. Huber, V. Jary, I. Konorov, D. Levit, J. Novy, D. Steffen, O. Subrt, M. Virius

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In general, state-of-the-art Data Acquisition Systems (DAQ) in high energy physics experiments must satisfy high requirements in terms of reliability, efficiency and data rate capability. This paper presents the development and deployment of a debugging tool named DAQ Debugger for the intelligent, FPGA-based Data Acquisition System (iFDAQ) of the COMPASS experiment at CERN. Utilizing a hardware event builder, the iFDAQ is designed to be able to readout data at the average maximum rate of 1.5 GB/s of the experiment. In complex softwares, such as the iFDAQ, having thousands of lines of code, the debugging process is absolutely essential to reveal all software issues. Unfortunately, conventional debugging of the iFDAQ is not possible during the real data taking. The DAQ Debugger is a tool for identifying a problem, isolating the source of the problem, and then either correcting the problem or determining a way to work around it. It provides the layer for an easy integration to any process and has no impact on the process performance. Based on handling of system signals, the DAQ Debugger represents an alternative to conventional debuggers provided by most integrated development environments. Whenever problem occurs, it generates reports containing all necessary information important for a deeper investigation and analysis. The DAQ Debugger was fully incorporated to all processes in the iFDAQ during the run 2016. It helped to reveal remaining software issues and improved significantly the stability of the system in comparison with the previous run. In the paper, we present the DAQ Debugger from several insights and discuss it in a detailed way.

Keywords: DAQ Debugger, data acquisition system, FPGA, system signals, Qt framework

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19467 Q-Map: Clinical Concept Mining from Clinical Documents

Authors: Sheikh Shams Azam, Manoj Raju, Venkatesh Pagidimarri, Vamsi Kasivajjala

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Over the past decade, there has been a steep rise in the data-driven analysis in major areas of medicine, such as clinical decision support system, survival analysis, patient similarity analysis, image analytics etc. Most of the data in the field are well-structured and available in numerical or categorical formats which can be used for experiments directly. But on the opposite end of the spectrum, there exists a wide expanse of data that is intractable for direct analysis owing to its unstructured nature which can be found in the form of discharge summaries, clinical notes, procedural notes which are in human written narrative format and neither have any relational model nor any standard grammatical structure. An important step in the utilization of these texts for such studies is to transform and process the data to retrieve structured information from the haystack of irrelevant data using information retrieval and data mining techniques. To address this problem, the authors present Q-Map in this paper, which is a simple yet robust system that can sift through massive datasets with unregulated formats to retrieve structured information aggressively and efficiently. It is backed by an effective mining technique which is based on a string matching algorithm that is indexed on curated knowledge sources, that is both fast and configurable. The authors also briefly examine its comparative performance with MetaMap, one of the most reputed tools for medical concepts retrieval and present the advantages the former displays over the latter.

Keywords: information retrieval, unified medical language system, syntax based analysis, natural language processing, medical informatics

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19466 Using Non-Negative Matrix Factorization Based on Satellite Imagery for the Collection of Agricultural Statistics

Authors: Benyelles Zakaria, Yousfi Djaafar, Karoui Moussa Sofiane

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Agriculture is fundamental and remains an important objective in the Algerian economy, based on traditional techniques and structures, it generally has a purpose of consumption. Collection of agricultural statistics in Algeria is done using traditional methods, which consists of investigating the use of land through survey and field survey. These statistics suffer from problems such as poor data quality, the long delay between collection of their last final availability and high cost compared to their limited use. The objective of this work is to develop a processing chain for a reliable inventory of agricultural land by trying to develop and implement a new method of extracting information. Indeed, this methodology allowed us to combine data from remote sensing and field data to collect statistics on areas of different land. The contribution of remote sensing in the improvement of agricultural statistics, in terms of area, has been studied in the wilaya of Sidi Bel Abbes. It is in this context that we applied a method for extracting information from satellite images. This method is called the non-negative matrix factorization, which does not consider the pixel as a single entity, but will look for components the pixel itself. The results obtained by the application of the MNF were compared with field data and the results obtained by the method of maximum likelihood. We have seen a rapprochement between the most important results of the FMN and those of field data. We believe that this method of extracting information from satellite data leads to interesting results of different types of land uses.

Keywords: blind source separation, hyper-spectral image, non-negative matrix factorization, remote sensing

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19465 Midwives’ Perceptions and Experiences of Recommending and Delivering Vaccines to Pregnant Women Following the COVID-19 Pandemic

Authors: Cath Grimley, Debra Bick, Sarah Hillman, Louise Clarke, Helen Atherton, Jo Parsons

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The problem: Women in the UK are offered influenza (flu), pertussis (whooping cough) and COVID-19 vaccinations during their pregnancy but uptake of all three vaccines is below the desired rate. These vaccines are offered during pregnancy as pregnant women are at an increased risk of hospitalisation, morbidity, and mortality from these illnesses. Exposure to these diseases during pregnancy can also have a negative impact on the unborn baby with an increased risk of serious complications both while in utero and following birth. The research aims to explore perceptions about the vaccinations offered in pregnancy both from the perspectives of pregnant women and midwives. To determine factors that influence pregnant women’s decisions about whether or not to accept the vaccines following the Covid-19 pandemic and to explore midwives’ experiences of recommending and delivering vaccines. The approach: This research follows a qualitative design involving semi-structured interviews with pregnant women and midwives in the UK. Interviews with midwives explored vaccination discussions they routinely have with pregnant women and identified some of the barriers to vaccination that pregnant women discuss with them. Interviews with pregnant women explored their views since the COVID-19 pandemic about vaccinations offered during pregnancy, and whether the pandemic has influenced perceptions of vulnerability to illness in pregnant women. Midwives were recruited via participating hospitals and midwife specific social media groups. Pregnant women were recruited via participating hospitals and community groups. All interviews were conducted remotely (using telephone or Microsoft Teams) and analysed using thematic analysis. Findings: 43 pregnant women and 16 midwives were recruited and interviewed. The findings presented here will focus on data from midwives. Topics identified included three key themes for midwives. These were 1) Delivery of vaccinations which includes the convenience of offering vaccinations while attending standard antenatal appointments and practical barriers faced in delivering these vaccinations at hospital. 2) Messages and guidance included the importance of up-to-date informational needs for midwives to deliver vaccines and that uncertainty and conflicting messages about the COVID-19 vaccine during pregnancy were a barrier to delivery. 3) Recommendations to have vaccines look at all aspects of recommendations such as how recommendations are communicated, the contents of the recommendation, the importance of the vaccine and the impact of those recommendations on whether women accept the vaccine. Implications: Findings highlight the importance for midwives to receive clear and consistent information so they can feel confident in relaying this information while recommending and delivering vaccines to pregnant women. Emphasising why vaccines are important when recommending vaccinations to pregnant women in addition to standard information on the availability and timing will add to the strength and impact of that recommendation in helping women to make informed decisions about accepting vaccines. The findings of this study will inform the development of an intervention to increase vaccination uptake amongst pregnant women.

Keywords: vaccination, pregnancy, qualitative, interviews, Covid-19, midwives

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19464 Determinants of Walking among Middle-Aged and Older Overweight and Obese Adults: Demographic, Health, and Socio-Environmental Factors

Authors: Samuel N. Forjuoh, Marcia G. Ory, Jaewoong Won, Samuel D. Towne, Suojin Wang, Chanam Lee

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The public health burden of obesity is well established as is the influence of physical activity (PA) on the health and wellness of individuals who are obese. This study examined the influence of selected demographic, health, and socioenvironmental factors on the walking behaviors of middle-aged and older overweight and obese adults. Online and paper surveys were administered to community-dwelling overweight and obese adults aged ≥ 50 years residing in four cities in central Texas and seen by a family physician in the primary care clinic from October 2013 to June 2014. Descriptive statistics were used to characterize participants’ anthropometric and demographic data as well as their health conditions and walking, socioenvironmental, and more broadly defined PA behaviors. Then Pearson chi-square tests were used to assess differences between participants who reported walking the recommended ≥ 150 minutes for any purpose in a typical week as a proxy to meeting the U.S. Centers for Disease Control and Prevention’s PA guidelines and those who did not. Finally, logistic regression was used to predict walking the recommended ≥ 150 minutes for any purpose, controlling for covariates. The analysis was conducted in 2016. Of the total sample (n=253, survey response rate of 6.8%), the majority were non-Hispanic white (81.7%), married (74.5%), male (53.5%), and reported an annual household income of ≥ $50,000 (65.7%). Approximately, half were employed (49.6%), or had at least a college degree (51.8%). Slightly more than 1 in 5 (n=57, 22.5%) reported walking the recommended ≥150 minutes for any purpose in a typical week. The strongest predictors of walking the recommended ≥ 150 minutes for any purpose in a typical week in adjusted analysis were related to education and a high favorable perception of the neighborhood environment. Compared to those with a high school diploma or some college, participants with at least a college degree were five times as likely to walk the recommended ≥ 150 minutes for any purpose (OR=5.55, 95% CI=1.79-17.25). Walking the recommended ≥ 150 minutes for any purpose was significantly associated with participants who disagreed that there were many distracted drivers (e.g., on the cell phone while driving) in their neighborhood (OR=4.08, 95% CI=1.47-11.36) and those who agreed that there are sidewalks or protected walkways (e.g., walking trails) in their neighborhood (OR=3.55, 95% CI=1.10-11.49). Those employed were less likely to walk the recommended ≥ 150 minutes for any purpose compared to those unemployed (OR=0.31, 95% CI=0.11-0.85) as were those who reported some difficulty walking for a quarter of a mile (OR=0.19, 95% CI=0.05-0.77). Other socio-environmental factors such as having care-giver responsibilities for elders, someone to walk with, or a dog in the household as well as Walk Score™ were not significantly associated with walking the recommended ≥ 150 minutes for any purpose in a typical week. Neighborhood perception appears to be an important factor associated with the walking behaviors of middle-aged and older overweight and obese individuals. Enhancing the neighborhood environment (e.g., providing walking trails) may promote walking among these individuals.

Keywords: determinants of walking, obesity, older adults, physical activity

Procedia PDF Downloads 242