Search results for: delirium prevention bundle
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1702

Search results for: delirium prevention bundle

562 Occupational Health in Dental Practice

Authors: Nino Chomakhashvili, Nino Chikhladze, Nato Pitskhelauri, Maia Bitskhinashvili

Abstract:

The dental practice is associated with occupational health challenges. Ergonomic risks in the workplace can significantly impair a dentist's work capacity and may even result in the premature end of their career. Implementing ergonomic principles in dental practice aims to prevent work-related musculoskeletal disorders. Many studies have been conducted in various countries such as Sweden, Denmark, Germany, Poland, and Australia to examine the prevalence of musculoskeletal disorders among dentists. However, to the best of authors knowledge there have been no studies on the application of ergonomic principles in dental practice in Georgia. This study focused on evaluating the ergonomic conditions of dental practice in Georgia and determining how common musculoskeletal disorders are among them. The survey was conducted using a random sampling method in selected dental clinics. A tailored questionnaire consisting of 40 questions, created using insights from international practices, was utilized for the study. Two hundred ninety-one filled questionnaires were used for the analysis. Most respondents reported that their workplaces adhered to ergonomic standards. However, 53.6% experienced frequent back pain, with 50.9% suffering from neck pain, 47.9% from shoulder pain, and 47.1% from lower back pain. Many noted that pain had caused them to reduce their working hours. Nearly all respondents expressed a desire to enhance their knowledge about ergonomics and the prevention of occupational diseases. They indicated a preference for participating in continuous professional development programs (61.5%), receiving information through leaflets (12.0%), and attending online webinars (26.6%). Integrating ergonomic principles into the dental practice is crucial for preventing work-related musculoskeletal disorders. It is essential to offer continuous professional development programs and provide information to dentists, via leaflets, thematic online or hybrid webinars.

Keywords: dental practice, ergonomic risks, musculoskeletal disorders, occupational health

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561 Findings from an Access Improvement Project for Antiretroviral Therapy Uptake through Traditional Birth Attendants at Mother Theresa Hospital, Lagos, Nigeria

Authors: Daniel Afolayan, Christina Olawepo, Francis Olowookanga, Nguhemen Tingir, Olawale Fadare, John Oko

Abstract:

In Nigeria, traditional birth attendants (TBAs) can play an important role in the prevention of mother-to-child transmission of HIV. However, their role in improving access to antiretroviral therapy (ART) is unclear. Catholic Caritas Foundation of Nigeria (Caritas Nigeria) is an implementing agency supporting increased access to HIV testing and treatment services in Lagos state through health facilities including Mother Theresa Hospital. Despite intra-facility testing and community outreaches, ART uptake at Mother Theresa Hospital, Lagos was low with 6 individuals on antiretroviral drugs 3 months post-activation. This study explored improving access to ART through linkages with TBAs for ART uptake at the facility. Plan-Do-Study-Act model was used. The goal was to improve uptake of ART from 6 to 80 in 5 months (end of project year). Scanning revealed a network of 15 TBAs with potential as satellites for HIV testing. Caritas Nigeria linked the facility with 15 TBAs who were provided with HIV test kits and trained on HIV testing services for provider-initiated testing and outreaches. Weekly reports and referrals of positives were received, tracked and feedback given on testing yield. These TBAs serve individuals of various age and gender at their trado-medical centres. At the end of 5 months, HIV testing increased by 10,575 (78% from TBAs) and HIV positives obtained improved by 77 (44.2% from TBAs). 55 new individuals were enrolled and commenced on ART (61.8% from TBAs). There was a successful linkage of all clients with escort services due to incentives. Total uptake of ART was 61 (76.3% of target). Structured partnerships between TBAs and HIV care and treatment centers should be strengthened to improve access to ART.

Keywords: access improvement, antiretroviral therapy, traditional birth attendants, uptake

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560 Enhancing the Stability of Vietnamese Power System - from Theory to Practical

Authors: Edwin Lerch, Dirk Audring, Cuong Nguyen Mau, Duc Ninh Nguyen, The Cuong Nguyen, The Van Nguyen

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The National Load Dispatch Centre of Electricity Vietnam (EVNNLDC) and Siemens PTI investigated the stability of the electrical 500/220 kV transportation system of Vietnam. The general scope of the investigations is improving the stability of the Vietnam power system and giving the EVNNLDC staff the capability to decide how to deal with expected stability challenges in the future, which are related to the very fast growth of the system. Rapid system growth leads to a very high demand of power transmission from North to South. This was investigated by stability studies of interconnected power system with neighboring countries. These investigations are performed in close cooperation and coordination with the EVNNLDC project team. This important project includes data collection, measurement, model validation and investigation of relevant stability phenomena as well as training of the EVNNLDC staff. Generally, the power system of Vietnam has good voltage and dynamic stability. The main problems are related to the longitudinal system with more power generation in the North and Center, especially hydro power, and load centers in the South of Vietnam. Faults on the power transmission system from North to South risks the stability of the entire system due to a high power transfer from North to South and high loading of the 500 kV backbone. An additional problem is the weak connection to Cambodia power system which leads to interarea oscillations mode. Therefore, strengthening the power transfer capability by new 500kV lines or HVDC connection and balancing the power generation across the country will solve many challenges. Other countermeasures, such as wide area load shedding, PSS tuning and correct SVC placement will improve and stabilize the power system as well. Primary frequency reserve should be increased.

Keywords: dynamic power transmission system studies, blackout prevention, power system interconnection, stability

Procedia PDF Downloads 359
559 Development of Monoclonal Antibodies against the Acute Hepatopancreatic Necrosis Disease Toxins

Authors: Naveen Kumar B. T., Anuj Tyagi, Niraj Kumar Singh, Visanu Boonyawiwat, Shanthanagouda A. H., Orawan Boodde, Shankar K. M., Prakash Patil, Shubhkaramjeet Kaur

Abstract:

Since 2009, Acute Hepatopancreatic Necrosis Disease (AHPND) outbreaks have increased rapidly, and these have led to the major economic losses to the global shrimp industry. In comparison to other treatments, passive immunity and monoclonal antibody (MAb) based farmer level kit have proved their importance in controlling and treating the diseases in the shrimp industry. In the present study, MAbs were produced against the recombinant PirB protein Vibrio parahaemolyticus strain causing AHPND. Briefly, Balb/C mice were immunized with rPirB at 15 days interval, and antibody titer was determined by ELISA. Spleen cells from mice showing high antibody titer were fused with SP2O myeloma cells for hybridoma production. Among 130 hybridomas, four showed high antibody titer and positive reactivity in an immunoblot assay. In Western blot assay, three out of four MAbs (4C4, 2C2 and 4G3) showed reactivity to rPirB protein. However, in the natural host, only Mab clone 4G3 show strong reactivity (with a strain of V. parahemolyticus causing EMS/AHPND). These clones also showed reactivity with less than 20 kDa proteins in AHPND free V. parahaemolyticus (Thailand stain). Further, on from MAb 4G3 clone, four panels of single cell MAbs clones (G3F5, G3B8, G3H2, and G3D6) were produced of which three showed strong positive reactivity to rPirB protein in the Western blot. These MAbs have potential for controlling and prevention of the AHPND through passive immunity and development of filed level rapid diagnostic kits.

Keywords: shrimp, economic loss, AHPND, MAb

Procedia PDF Downloads 253
558 Impact of Quality Assurance Mechanisms on the Work Efficiency of Staff in the Educational Space of Georgia

Authors: B. Gechbaia, K. Goletiani, G. Gabedava, N. Mikeltadze

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At this stage, Georgia is a country which is actively involved in the European integration process, for which the primary priority is effective integration in the European education system. The modern Georgian higher education system is the process of establishing a new sociocultural reality, whose main priorities are determined by the Quality System as a continuous cycle of planning, implementation, checking and acting. Obviously, in this situation, the issue of management of education institutions comes out in the foreground, since the proper planning and implementation of personnel management processes is one of the main determinants of the company's performance. At the same time, one of the most important factors is the psychological comfort of the personnel, ensuring their protection and efficiency of stress management policy. The purpose of this research is to determine how intensely the relationship is between the psychological comfort of the personnel and the efficiency of the quality system in the institution as the quality assurance mechanisms of educational institutions affect the stability of personnel, prevention and management of the stressful situation. The research was carried out within the framework of the Internal Grant Project «The Role of Organizational Culture in the Process of Settlement of Management of Stress and Conflict, Georgian Reality and European Experience » of the Batumi Navigation Teaching University, based on the analysis of the survey results of target groups. The small-scale research conducted by us has revealed that the introduction of quality assurance system and its active implementation increased the quality of management of Georgian educational institutions, increased the level of universal engagement in internal and external processes and as a result, it has improved the quality of education as well as social and psychological comfort indicators of the society.

Keywords: quality assurance, effective management, stability of personnel, psychological comfort, stress management

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557 Determination of Some Organochlorine Pesticide Residues in Vegetable and Soil Samples from Alau Dam and Gongulong Agricultural Sites, Borno State, North Eastern Nigeria

Authors: Joseph Clement Akan, Lami Jafiya, Zaynab Muhammad Chellube, Zakari Mohammed, Fanna Inna Abdulrahman

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Five vegetables (spinach, lettuce, cabbage, tomato, and onion) were freshly harvested from the Alau Dam and Gongulong agricultural areas for the determination of some organochlorine pesticide residues (o, p-DDE, p,p’-DDD, o,p’-DDD, p,p’-DDT, α-BHC, γ-BHC, metoxichlor, lindane, endosulfan dieldrin, and aldrin.) Soil samples were also collected at different depths for the determination of the above pesticides. Samples collection and preparation were conducted using standard procedures. The concentrations of all the pesticides in the soil and vegetable samples were determined using GC/MS SHIMADZU (GC-17A) equipped with electron capture detector (ECD). The highest concentration was that of p,p’-DDD (132.4±13.45µg/g) which was observed in the leaf of cabbage, while the lowest concentration was that of p,p’-DDT (2.34µg/g) was observed in the root of spinach. Similar trends were observed at the Gongulong agricultural area, with p,p’-DDD having the highest concentration of 153.23µg/g in the leaf of cabbage, while the lowest concentration was that of p,p’-DDT (12.45µg/g) which was observed in the root of spinach. α-BHC, γ-BHC, Methoxychlor, and lindane were detected in all the vegetable samples studied. The concentrations of all the pesticides in the soil samples were observed to be higher at a depth of 21-30cm, while the lowest concentrations were observed at a depth of 0-10cm. The concentrations of all the pesticides in the vegetables and soil samples from the two agricultural sites were observed to be at alarming levels, much higher than the maximum residue limits (MRLs) and acceptable daily intake values (ADIs) .The levels of the pesticides observed in the vegetables and soil samples investigated, are of such a magnitude that calls for special attention and laws to regulate the use and circulation of such chemicals. Routine monitoring of pesticide residues in these study areas is necessary for the prevention, control and reduction of environmental pollution, so as to minimize health risks.

Keywords: Alau Dam, gongulong, organochlorine, pesticide residues, soil, vegetables

Procedia PDF Downloads 284
556 Reality Shock Affecting the Motivation to Work of New Flight Attendants: An Exploratory Qualitative Study of Flight Attendants Who Left Their Jobs Early

Authors: Hiromi Takafuji

Abstract:

Flight attendant:FA is one of popular occupation, especially in Asian countries, and the decision to be hired is made after clearing a high multiplier. On the other hand, immediately after joining the company, they experience unique stress due to the fact that the organization requires them to perform security and customer service duties in a highly specialized and limited space and time. As a result, despite the high level of difficulty in joining the company, many new recruits retire early at a high rate. It is commonly said that 30% of new graduates leave the company within three years in Japan and speculated that Reality Shock:RS is one of the causes of this. RS is that newcomers experience refers to the stress caused by the difference between pre-employment expectations and post-employment reality. The purpose of this study was to elucidate the mechanism by which the expertise required of new FA and the expectation of expertise held by each of them cause reality shock, which affects motivation and the decision to leave. This study identified the professionalism required of new FA and the impact of that expectation for professionalism on RS through an exploratory study of the experiences and psychological processes of FA who left within three years. Semi-structured in-depth interviews were conducted with five FA who left a major Japanese airline at an early stage, and their experiences were categorized, integrated, and classified by qualitative content analysis. They were chosen under a number of controlled conditions. Then two major findings emerged: first, that pre-employment expectations defining RS were hierarchical, and second, that training amplified expectations of professionalism, which strongly influenced early turnover. From these, this study generated a model of RS generative process model of FA that expectations are hierarchical and influential. This could contribute to the prevention of mental health deterioration by reality shock among new FA.

Keywords: reality shock, flight attendant, early turnover, qualitative study

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555 The Analysis of Regulation on Sustainability in the Financial Sector in Lithuania

Authors: Dalia Kubiliūtė

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Lithuania is known as a trusted location for global business institutions, and it attracts investors with it’s competitive environment for financial service providers. Along with the aspiration to offer a strong results-oriented and innovations-driven environment for financial service providers, Lithuanian regulatory authorities consistently implement the European Union's high regulatory standards for financial activities, including sustainability-related disclosures. Since European Union directed its policy towards transition to a climate-neutral, green, competitive, and inclusive economy, additional regulatory requirements for financial market participants are adopted: disclosure of sustainable activities, transparency, prevention of greenwashing, etc. The financial sector is one of the key factors influencing the implementation of sustainability objectives in European Union policies and mitigating the negative effects of climate change –public funds are not enough to make a significant impact on sustainable investments, therefore directing public and private capital to green projects may help to finance the necessary changes. The topic of the study is original and has not yet been widely analyzed in Lithuanian legal discourse. There are used quantitative and qualitative methodologies, logical, systematic, and critical analysis principles; hence the aim of this study is to reveal the problem of the implementation of the regulation on sustainability in the Lithuanian financial sector. Additional regulatory requirements could cause serious changes in financial business operations: additional funds, employees, and time have to be dedicated in order for the companies could implement these regulations. Lack of knowledge and data on how to implement new regulatory requirements towards sustainable reporting causes a lot of uncertainty for financial market participants. And for some companies, it might even be an essential point in terms of business continuity. It is considered that the supervisory authorities should find a balance between financial market needs and legal regulation.

Keywords: financial, legal, regulatory, sustainability

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554 Analyzing Doctors’ Knowledge of the United Kingdom Chief Medical Officer's Guidelines for Physical Activity: Survey of Secondary Care Doctors in a District General Hospital

Authors: Alexandra Von Guionneau, William Sloper, Charlotte Burford

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The benefits of exercise for the prevention and management of chronic disease are well established and the importance of primary care practitioners in promoting exercise is becoming increasingly recognized. However, those with severe manifestations of the chronic disease are managed in a secondary care setting. Secondary care practitioners, therefore, have a role to play in promoting physical activity. Methods: In order to assess secondary care doctors’ knowledge of the Chief Medical Officer’s guidelines for physical activity, a 12-question survey was administered to staff working in a district general hospital in South England during team and unit meetings. Questions related to knowledge of the current guidelines for both 19 - 64 year olds and older adults (65 years and above), barriers to exercise discussion or prescription and doctors’ own exercise habits. Responses were collected anonymously and analyzed using SPSS Version 24.0. Results: 96 responses were collected. Doctors taking part in the survey ranged from foundation years (26%) to consultants (40%). 17.7% of participants knew the guidelines for moderate intensity activity for 19 - 64 year olds. Only one participant knew all of the guidance for both 19 - 64 year olds and older adults. While 71.6% of doctors felt they were adequately informed about how to exercise, only 45.6% met the minimum recommended guidance for moderate intensity activity. Conclusion: More work is needed to promote the physical activity guidelines and exercise prescription to doctors working within a secondary care setting. In addition, doctors require more support to personally meet the recommended minimum level of physical activity.

Keywords: exercise is medicine, exercise prescription, physical activity guidelines, exercise habits

Procedia PDF Downloads 250
553 Epidemiology of Cutaneous Malignant Melanoma in Pakistan: Incidence, Clinical Subtypes, Tumor Stage and Localization

Authors: Warda Jabeen, Romaisa Shamim Khan, Osama Shakeel, Ahmed Faraz Bhatti, Raza Hussain

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Background: The worldwide incidence of cutaneous melanoma (CM) has been on the rise over the past few decades. Primary prevention and early treatment remain the focus of management to reduce the burden of disease. This entails identification of risk factors to prompt early diagnosis. In Pakistan, there is a scarcity of clinico-pathological data relating to cutaneous malignant melanoma. Objective: The purpose of this study was to analyze the epidemiological and clinical characteristics of patients presenting with cutaneous malignant melanoma in Pakistan, and to compare the results with other studies. Method: Shaukat Khanum Memorial Cancer Hospital and Research Centre is currently the only dedicated cancer hospital in the country, accepting patients from all over Pakistan. Majority of the patients, however, belong to the northern half of the country. From the recorded data of the hospital, all cutaneous melanoma cases were identified and evaluated. Results: Between 1997 and 2017, a total of 169 cutaneous melanoma patients were registered at Shaukat Khanum. Mean age was 47.5 years. The highest incidence of melanoma was seen in the age group 40-59 years (n=69, 40.8%). Most commonly reported clinical subtype was unspecified melanoma (n=154, 91%). Amongst those in which T stage was reported, the most frequently observed T-stage at presentation was T4 (n=23, 13.6%). With regards to body distribution, in our study CM was seen most commonly in the lower limb including the hip. The yearly incidence of melanoma has increased/remained stable from 2007 to 2017. Conclusion: cutaneous malignant melanoma is a fairly common disease in Pakistan. Patients tend to present at a more advanced stage as compared to patients in developed countries. Identification of risk factors and tumor characteristics is therefore of paramount importance to deal with these patients.

Keywords: epidemiology of cutaneous malignant melanoma, cutaneous malignant melanoma, Pakistan, skin cancer

Procedia PDF Downloads 136
552 A Survey on Students' Intentions to Dropout and Dropout Causes in Higher Education of Mongolia

Authors: D. Naranchimeg, G. Ulziisaikhan

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Student dropout problem has not been recently investigated within the Mongolian higher education. A student dropping out is a personal decision, but it may cause unemployment and other social problems including low quality of life because students who are not completed a degree cannot find better-paid jobs. The research aims to determine percentage of at-risk students, and understand reasons for dropouts and to find a way to predict. The study based on the students of the Mongolian National University of Education including its Arkhangai branch school, National University of Mongolia, Mongolian University of Life Sciences, Mongolian University of Science and Technology, Mongolian National University of Medical Science, Ikh Zasag International University, and Dornod University. We conducted the paper survey by method of random sampling and have surveyed about 100 students per university. The margin of error - 4 %, confidence level -90%, and sample size was 846, but we excluded 56 students from this study. Causes for exclusion were missing data on the questionnaire. The survey has totally 17 questions, 4 of which was demographic questions. The survey shows that 1.4% of the students always thought to dropout whereas 61.8% of them thought sometimes. Also, results of the research suggest that students’ dropouts from university do not have relationships with their sex, marital and social status, and peer and faculty climate, whereas it slightly depends on their chosen specialization. Finally, the paper presents the reasons for dropping out provided by the students. The main two reasons for dropouts are personal reasons related with choosing wrong study program, not liking the course they had chosen (50.38%), and financial difficulties (42.66%). These findings reveal the importance of early prevention of dropout where possible, combined with increased attention to high school students in choosing right for them study program, and targeted financial support for those who are at risk.

Keywords: at risk students, dropout, faculty climate, Mongolian universities, peer climate

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551 Domestic Rooftop Rainwater Harvesting for Prevention of Urban Flood in the Gomti Nagar Region of Lucknow, Uttar Pradesh, India

Authors: Rajkumar Ghosh

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Urban flooding is a common occurrence throughout Asia. Almost every city is vulnerable to urban floods in some fashion, and city people are particularly vulnerable. Pluvial and fluvial flooding are the most prominent causes of urban flooding in the Gomti Nagar region of Lucknow, Uttar Pradesh, India. The pluvial flooding is regarded to be less damaging because it is caused by heavy rainfall, Seasonal rainfall fluctuations, water flows off concrete infrastructures, blockages of the drainage system, and insufficient drainage capacity or low infiltration capacity. However, this study considers pluvial flooding in Lucknow to be a significant source of cumulative damage over time, and the risks of such events are increasing as a result of changes in ageing infrastructure, hazard exposure, rapid urbanization, massive water logging and global warming. As a result, urban flooding has emerged as a critical field of study. The popularity of analytical approaches to project the spatial extent of flood dangers has skyrocketed. To address future urban flood resilience, more effort is needed to enhance both hydrodynamic models and analytical tools to simulate risks under present and forecast conditions. Proper urban planning with drainage system and ample space for high infiltration capacity are required to reduce urban flooding. A better India with no urban flooding is a pipe dream that can be realized by putting household rooftop rainwater collection systems in every structure. According to the current study, domestic RTRWHs are strongly recommended as an alternative source of water, as well as to prevent surface runoff and urban floods in this region of Lucknow, urban areas of India.

Keywords: rooftop rainwater harvesting, urban flood, pluvial flooding, fluvial flooding

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550 The Influence of Bacteriocins Producing Lactic Acid Bacteria Multiplied in an Alternative Substrate on Calves Blood Parameters

Authors: E. Bartkiene, V. Krungleviciute, J. Kucinskiene, R. Antanaitis, A. Kucinskas

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In calves less than 10-day-old, infection commonly cause severe diarrhoea and high mortality. To prevention of calves diseases a common practice is to treat calves with prophylactic antibiotics, in this case the use of lactic acid bacteria (LAB) is promising. Often LAB strains are incubated in comercial de Man-Rogosa-Sharpe (MRS) medium, the culture are centrifuged, the cells are washing with sterile water, and this suspension is used as a starter culture for animal health care. Juice of potatoe tubers is industrial wastes, wich may constitute a source of digestible nutrients for microorganisms. In our study the ability of LAB to utilize potatoe tubers juice in cell synthesis without external nutrient supplement was investigated, and the influence of multiplied LAB on calves blood parameters was evaluated. Calves were selected based on the analogy principle (treatment group (n=6), control group (n=8)). For the treatment group 14 days was given a 50 ml of fermented potatoe tubers juice containing 9.6 log10 cfu/ml of LAB. Blood parameters (gas and biochemical) were assessed by use of an auto-analyzers (Hitachi 705 and EPOC). Before the experiment, blood pH of treatment group calves was 7.33, control – 7.36, whereas, after 14 days, 7.28 and 7.36, respectively. Calves blood pH in the treatment group remained stable over the all experiment period. Concentration of PCO2 in control calves group blood increased from 63.95 to 70.93, whereas, in the treatment group decreased from 63.08 to 60.71. Concentration of lactate in the treatment group decreased from 3.20 mmol/l to 2.64 mmol/l, whereas, in control - increased from 3.95 mmol/l to 4.29 mmol/l. Concentration of AST in the control calves group increased from 50.18 IU/L to 58.9 IU/L, whereas, in treatment group decreased from 49.82 IU/L to 33.1 IU/L. We conclude that the 50 ml of fermented potatoe tubers juice containing 9.6 log10 cfu/ml of LAB per day, by using 14 days, reduced risk of developing acidosis (stabilizes blood pH (p < 0.05)), reduces lactates and PCO2 concentration (p < 0.05) and risk of liver lesions (reduces AST concentration (p < 0.005)) in blood of calves.

Keywords: alternative substrate, blood parameters, calves, lactic acid bacteria

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549 An Experience of HIV Testing and Counseling Services at a Tertiary Care Center of Bangladesh

Authors: S. M. Rashed Ul Islam, Shahina Tabassum, Afsana Anwar Miti

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Objective: HIV testing and counseling center (HTC) is an important component of the HIV/AIDS detection, prevention and control interventions. The service was first initiated at the Department of Virology, Bangabandhu Sheikh Mujib Medical University (BSMMU) since the first case detection in 1989. The present study aimed to describe the demographic profile among the attendees tested HIV positive. Methods: The present study was carried out among 219 HIV positive cases detected through screening at the Department of Virology of BSMMU during the year of 2012-2016. Data were collected through pre-structured written questionnaire during the counseling session. Data were expressed as frequency and percentages and analyzed using SPSS v20.0 program. Results: Out of 219 HIV cases detected, 77.6% were males, and 22.4% were females with a mean age (mean±SD) of 35.46±9.46 years. Among them, 70.7% belonged to the 26-45 age groups representing the sexually active age. The majority of the cases were married (86.3%) and 49.8% had primary level of education whereas, 8.7% were illiterate. Nearly 42% of cases were referred from Chittagong division (south-east part of the country) followed by Dhaka division (35.6%). The bulk of study population admitted to involvement in high-risk behaviour (90%) in the past and 42% of them had worked overseas. The Pearson Chi-square (χ2) analysis revealed significant relationship of gender with marital (χ2=7.88 at 2% level) and occupation status (χ2=120.48 at 6% level); however, no association was observed with risk behaviour and educational status. Recommendations: HIV risk behavior was found to be a prime source for HIV infection among the study population. So, there is need for health education and awareness program to bring about behavioral changes to halt the yearly increase of new cases in the country with special attention to our overseas workers on HIV/AIDS risk and safety.

Keywords: Bangladesh, health education, HIV testing and counseling (HTC), HIV/AIDS, risk behavior

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548 Extent of Knowledge, Preparedness and Perception on Telemedicine among Family Medicine Resident Physicians in Different Training Institutions in Cebu City, PH during COVID-19 Pandemic

Authors: Kristine Joy Y. Sumanga, Clarissa Mae D. Derecho

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Telemedicine is providing health care services using electronic means at a distance, including the diagnosis, treatment, and prevention of diseases as well as the research and evaluation and education of health care providers. The role of telemedicine in this time of the COVID-19 pandemic is vital, especially in the practice of medicine. General Objective: To determine the extent of knowledge, preparedness and perception of telemedicine among Family Medicine Resident Physicians in different training institutions in Cebu City during the Coronavirus Disease 19 pandemic. Methods: A descriptive, cross-sectional survey research study was conducted in four hospital training institutions in Cebu City. A total of 41 respondents gave their consent and were given the online survey questionnaire pertaining to the extent of knowledge, preparedness and perceptions on telemedicine, including respondents’ demographic data and problems encountered in Telemedicine. Results: Out of the 41 respondents, 56.10% were young adults (26 to 30 years old), mostly females (70.73%), single (68.29%), first-year residents (43.90%), employed at a government hospital (70.73%) and are in the traditional residency pathway (82.93%). On relevant experience, 82.93% experienced telemedicine during residency, with 100% on follow-up consultations, and 95% were consulted due to infections. Respondents’ extent of knowledge was average, while the extent of preparedness and perception were great. Problems with low connectivity (80.48%) were noted by most of the respondents. Conclusion: Resident physicians moderately understood the information about telemedicine but with a great extent of preparedness and perception. They are always prepared for telemedicine modality because they are fully aware of its existence and need in the delivery of health care services among their patients at the time of the pandemic. Challenges to low connectivity and handling patients’ data privacy were the major concerns met by the resident physicians in the use of telemedicine.

Keywords: telemedicine, knowledge, preparedness, perception, family medicine, residents, COVID 19

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547 Assessing the Indicators Influencing Port Resilience: A Comprehensive Literature Review

Authors: Guo Rui, Cao Xinhu

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In recent decades, the world has endured severe challenges in light of climate change, epidemics, geopolitics, terrorism, economic uncertainties, as well as regional conflicts and rivalries. The appropriate use of critical infrastructures (Cis) is confronted. Ports, as typical Cis cover more than 80% of the global freight movement. Within this context, even the minimal disruption of port operations could cause malfunction of the holistic supply chain network and substantial economic losses. Hence, it is crucial to evaluate port performance from the perspective of resilience. Research on resilience and risk/safety management has been increasing, however, it needs more attention, as it could prevent potential socio-economic losses and inspire decision-makers to make resilience-based decisions to answer the challenges, such as COVID-19. To facilitate better moves from decision-makers, ports need to identify proper factors influencing port resilience. Inappropriately influenced factor selection could have a cascading effect on undesirable port performances. Thus, a systematic evaluation of factors is essential to stimulate the improvement process of port resilience investigation. This study zooms into container ports considering their critical role in international trade and global supply chains. 440 articles are selected after relevance ranking, and consequently, 62 articles are scrutinized after the title and abstract screening. Forty-one articles are included for bibliographic analysis in the end. It is found that there is no standardized index system to measure port resilience. And most studies evaluate port resilience merely in the recovery phase. Only two articles cover absorption, adaption and recovery state. However, no literature involves the prevention state. Hence, a uniform resilience index system is expected with a clear resilience definition. And port safety and security should also be considered while evaluating port resilience.

Keywords: port resilience, port safety and security, literature review, index system, port performance

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546 SARS-CoV-2 Transmission Risk Factors among Patients from a Metropolitan Community Health Center, Puerto Rico, July 2020 to March 2022

Authors: Juan C. Reyes, Linnette Rodríguez, Héctor Villanueva, Jorge Vázquez, Ivonne Rivera

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On July 2020, a private non-profit community health center (HealthProMed) that serves people without a medical insurance plan or with limited resources in one of the most populated areas in San Juan, Puerto Rico, implemented a COVID-19 case investigation and contact-tracing surveillance system. Nursing personnel at the health center completed a computerized case investigation form that was translated, adapted, and modified from CDC’s Patient Under Investigation (PUI) Form. Between July 13, 2020, and March 17, 2022, a total of 9,233 SARS-CoV-2 tests were conducted at the health center, 16.9% of which were classified as confirmed cases (positive molecular test) and 27.7% as probable cases (positive serologic test). Most of the confirmed cases were females (60.0%), under 20 years old (29.1%), and living in their homes (59.1%). In the 14 days before the onset of symptoms, 26.3% of confirmed cases reported going to the supermarket, 22.4% had contact with a known COVID-19 case, and 20.7% went to work. The symptoms most commonly reported were sore throat (33.4%), runny nose (33.3%), cough (24.9%), and headache (23.2%). The most common preexisting medical conditions among confirmed cases were hypertension (19.3%), chronic lung disease including asthma, emphysema, COPD (13.3%), and diabetes mellitus (12.8). Multiple logistic regression analysis revealed that patients who used alcohol frequently during the last two weeks (OR=1.43; 95%CI: 1.15-1.77), those who were in contact with a positive case (OR=1.58; 95%CI: 1.33-1.88) and those who were obese (OR=1.82; 95%CI: 1.24-2.69) were significantly more likely to be a confirmed case after controlling for sociodemographic variables. Implementing a case investigation and contact-tracing component at community health centers can be of great value in the prevention and control of COVID-19 at the community level and could be used in future outbreaks.

Keywords: community health center, Puerto Rico, risk factors, SARS-CoV-2

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545 Child Labor and Injury Occurrence in Nicaragua: A Gender Perspective Analysis

Authors: Cristina Domínguez, Steven N. Cuadra

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Aims: The aims of this study are: 1) to describe the occurrence and estimate the risk of suffering injuries of any kind, especially work-related injuries, in rural children working in agricultural activities and in urban children working on the street 2) to explore factors that might be associated with the occurrence of work-related injuries among child workers such as gender, school attendance, and performance of household chore. Method: We performed a crossectional study among working children in agricultural activities (120) and on the street (108) and in non-working referents (140) in 2019. We investigated self-reported injuries during the last 12 months, with focus on work-related injuries. Incidence rate, rate ratios, and 95% CI were calculated by Poisson regression. Results: Agricultural workers have a higher incidence of work-related injuries (2.1 per 1000 person-days) than children working on the street (1.8 per 1000 person-days). However, when considering girl’s unpaid work at home, girls had higher occurrence. Girls had a 30% increase on the risk of suffering work related injuries compared to boys. Performing household chore and attending school were the major predictors of injury occurrence. Discussion: Our data suggest If such partial and full-time girl’s housework is taken into account, there would be little or no variation between the sexes with regard to injuries occurrence, and the incidence rate of work related injuries among girls could even exceed that of boys A greater understanding of the interaction of factors related to how child workers spend their time, and its impact on children’s health, is needed in order to identify feasible and appropriate strategies to reduce the negative effect of work on children when elimination of child labor is not reachable in the short term. Clearly, gender aspects on child labor may allow for more effective targeting of prevention efforts.

Keywords: injuries, child labor, agricultural work, gender

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544 The Impact of Simulation-based Learning on the Clinical Self-efficacy and Adherence to Infection Control Practices of Nursing Students

Authors: Raeed Alanazi

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Introduction: Nursing students have a crucial role to play in the inhibition of infectious diseases and, therefore, must be trained in infection control and prevention modules prior to entering clinical settings. Simulations have been found to have a positive impact on infection control skills and the use of standard precautions. Aim: The purpose of this study was to use the four sources of self-efficacy in explaining the level of clinical self-efficacy and adherence to infection control practices in Saudi nursing students during simulation practice. Method: A cross-sectional design with convenience sampling was used. This study was conducted in all Saudi nursing schools, with a total number of 197 students participated in this study. Three scales were used simulation self- efficacy Scale (SSES), the four sources of self-efficacy scale (SSES), and Compliance with Standard Precautions Scale (CSPS). Multiple linear regression was used to test the use of the four sources of self-efficacy (SSES) in explaining level of clinical self-efficacy and adherence to infection control in nursing students. Results: The vicarious experience subscale (p =.044) was statistically significant. The regression model indicated that for every one unit increase in vicarious experience (observation and reflection in simulation), the participants’ adherence to infection control increased by .13 units (β =.22, t = 2.03, p =.044). In addition, the regression model indicated that for every one unit increase in education level, the participants’ adherence to infection control increased by 1.82 units (beta=.34= 3.64, p <.001). Also, the mastery experience subscale (p <.001) and vicarious experience subscale (p = .020) were shared significant associations with clinical self-efficacy. Conclusion: The findings of this research support the idea that simulation-based learning can be a valuable teaching-learning method to help nursing students develop clinical competence, which is essential in providing quality and safe nursing care.

Keywords: simulation-based learning, clinical self-efficacy, infection control, nursing students

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543 Using Seismic and GPS Data for Hazard Estimation in Some Active Regions in Egypt

Authors: Abdel-Monem Sayed Mohamed

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Egypt rapidly growing development is accompanied by increasing levels of standard living particular in its urban areas. However, there is a limited experience in quantifying the sources of risk management in Egypt and in designing efficient strategies to keep away serious impacts of earthquakes. From the historical point of view and recent instrumental records, there are some seismo-active regions in Egypt, where some significant earthquakes had occurred in different places. The special tectonic features in Egypt: Aswan, Greater Cairo, Red Sea and Sinai Peninsula regions are the territories of a high seismic risk, which have to be monitored by up-to date technologies. The investigations of the seismic events and interpretations led to evaluate the seismic hazard for disaster prevention and for the safety of the dense populated regions and the vital national projects as the High Dam. In addition to the monitoring of the recent crustal movements, the most powerful technique of satellite geodesy GPS are used where geodetic networks are covering such seismo-active regions. The results from the data sets are compared and combined in order to determine the main characteristics of the deformation and hazard estimation for specified regions. The final compiled output from the seismological and geodetic analysis threw lights upon the geodynamical regime of these seismo-active regions and put Aswan and Greater Cairo under the lowest class according to horizontal crustal strains classifications. This work will serve a basis for the development of so-called catastrophic models and can be further used for catastrophic risk management. Also, this work is trying to evaluate risk of large catastrophic losses within the important regions including the High Dam, strategic buildings and archeological sites. Studies on possible scenarios of earthquakes and losses are a critical issue for decision making in insurance as a part of mitigation measures.

Keywords: b-value, Gumbel distribution, seismic and GPS data, strain parameters

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542 Designing of Oat Drink with Phytonutrients Assigned for Pro-Health Oriented Consumers

Authors: Gramza-Michalowska Anna, Skrety Joanna, Anna Zywica, Kobus-Cisowska Joanna, Kmiecik Dominik, Korczak Jozef

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Background: Modern consumer highly appreciates the positive influence of consumed products on well-being and overall health. High acceptance of new food is a result of intensified research showing many proofs confirming that food offers significant prophylactic and therapeutic potential, next to its basic nutritional function. Objective: Proposition of the technology of unsweetened oat drinks enriched with plant extracts for pro-health oriented individuals. We investigated the effects of selected plant extracts addition on antioxidative capacity and consumer’s acceptance of drinks as representative of all day diet product. Methods: The analysis of the basic composition and antioxidant properties of the drinking product was conducted. Basic composition included protein, lipids and fiber content. Antioxidant capacity of drink was evaluated with use radical scavenging methods (DPPH, ABTS), ORAC value and FRAP. Proposed drink as new product was also characterized with sensory analysis, which included color, aroma, taste, consistency and overall acceptance. Results: Results showed that addition of plant extracts into a oat drink allowed to enhance its antioxidant potential and influenced significantly its sensory values. The preferred composition and properties of designed beverage permit claim that it can have a positive impact on the health of the consumers. Conclusion: Designed oat drink would be an answer for pro-healthy life style of the consumers. Results showed that product with plant extracts addition would be accepted by the consumers and because of its antioxidative potential could be an important factor in prevention of free radicals influence on human organism.

Keywords: phytonutrients, pro-health, well-being, antioxidant potential, sensory value

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541 Molecular and Serological Diagnosis of Newcastle and Ornithobacterium rhinotracheale Broiler in Chicken in Fars Province, Iran

Authors: Mohammadjavad Mehrabanpour, Maryam Ranjbar Bushehri, Dorsa Mehrabanpour

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Respiratory diseases are the most important problems in the country’s poultry industry, particularly when it comes to broiler flocks. Ornithobacterium rhinotracheale (ORT) is a species that causes poor performance in growth rate, egg production, and mortality. This pathogen causes a respiratory infection including pulmonary alveolar inflammation, and pneumonia of birds throughout the world. Newcastle disease (ND) is a highly contagious disease in poultry, and also, it causes considerable losses to the poultry industry. The aim of this study was to evaluate the simultaneous occurrence of ORT and ND and NDV isolation by inoculation in embryonated eggs and confirmed by RT-PCR in broiler chicken flocks in Fars province. In this study, 318 blood and 85 tissue samples (brain, trachea, liver, and cecal tonsils) were collected from 15 broiler chicken farms. Survey serum antibody titers against ORT by using a commercial enzyme-linked immunosorbent assay (ELISA) kit performed. Evaluation of antibody titer against ND virus is performed by hemagglutination inhibition test. Virus isolation with chick embryo eggs 9-11 and RT-PCR method were carried out. A total of 318 serum samples, 135 samples (42.5%) were positive for antibodies to ORT and titer of HI antibodies against NDV in 122 serum samples (38/4%) were 7-10 (log2) and 61 serum samples (19/2%) had occurrence antibody titer against Newcastle virus and ORT. Results of the present study indicated that 20 tissue samples were positive in embryonated egg and in rapid hemagglutination (HA) test. HI test with specific ND positive serum confirmed that 6 of 20 samples. PCR confirmed that all six samples were positive and PCR products of samples indicated 535-base pair fragments in electrophrosis. Due to the great economic importance of these two diseases in the poultry industry, it is necessary to design and implement a comprehensive plan for prevention and control of these diseases.

Keywords: ELISA, Ornithobacterium rhinotracheale, newcastle disease, seroprevalence

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540 The Role of Non-Governmental Organizations in Combating Human Trafficking in South India: An Overview

Authors: Kumudini Achchi

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India, being known for its rich cultural values has given a special place to women who are also been victims of humiliation, torture, and exploitation. The major share of Human Trafficking goes to sex trafficking which is recognised as world’s second most huge social evil. The original form of sex trafficking in India is prostitution with and without religious sanction. Today the situation of such women reached as an issue of human rights where they rights are denied severely. This situation demanded intervention to protect them from the exploitative situation. NGO are the proactive initiatives which offer support to the exploited women in sex trade. To understand the intervention programs of NGOs in South India, a study was conducted covering four states and a union territory considering 32 NGOs based on their preparedness to participate in the research study. Descriptive and diagnostic research design was adopted along with interview schedule as a tool for collecting data. The study reveals that these NGOs believes in the possibility of mainstreaming commercially sexually exploited women and found adopted seven different programs in the process such as rescue, rehabilitation, reintegration, prevention, developmental, advocacy and research. Each area involves different programs to reach and prepare the exploited women towards mainstreamed society which has been discussed in the paper. Implementation of these programs is not an easy task for the organizations rather they are facing hardships in the areas such as social, legal, financial, political which are hindering the successful operations. Rescue, advocacy, and research are the least adopted areas by the NGOs because of lack of support as well as knowledge in the area. Rehabilitation stands as the most adopted area in implementation. The paper further deals with the challenges in the implementation of the programs as well as the remedial measures in social work point of view having Indian cultural background.

Keywords: NGOs, commercially sexually exploited women, programmes, South India

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539 A Hybrid Model of Structural Equation Modelling-Artificial Neural Networks: Prediction of Influential Factors on Eating Behaviors

Authors: Maryam Kheirollahpour, Mahmoud Danaee, Amir Faisal Merican, Asma Ahmad Shariff

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Background: The presence of nonlinearity among the risk factors of eating behavior causes a bias in the prediction models. The accuracy of estimation of eating behaviors risk factors in the primary prevention of obesity has been established. Objective: The aim of this study was to explore the potential of a hybrid model of structural equation modeling (SEM) and Artificial Neural Networks (ANN) to predict eating behaviors. Methods: The Partial Least Square-SEM (PLS-SEM) and a hybrid model (SEM-Artificial Neural Networks (SEM-ANN)) were applied to evaluate the factors affecting eating behavior patterns among university students. 340 university students participated in this study. The PLS-SEM analysis was used to check the effect of emotional eating scale (EES), body shape concern (BSC), and body appreciation scale (BAS) on different categories of eating behavior patterns (EBP). Then, the hybrid model was conducted using multilayer perceptron (MLP) with feedforward network topology. Moreover, Levenberg-Marquardt, which is a supervised learning model, was applied as a learning method for MLP training. The Tangent/sigmoid function was used for the input layer while the linear function applied for the output layer. The coefficient of determination (R²) and mean square error (MSE) was calculated. Results: It was proved that the hybrid model was superior to PLS-SEM methods. Using hybrid model, the optimal network happened at MPLP 3-17-8, while the R² of the model was increased by 27%, while, the MSE was decreased by 9.6%. Moreover, it was found that which one of these factors have significantly affected on healthy and unhealthy eating behavior patterns. The p-value was reported to be less than 0.01 for most of the paths. Conclusion/Importance: Thus, a hybrid approach could be suggested as a significant methodological contribution from a statistical standpoint, and it can be implemented as software to be able to predict models with the highest accuracy.

Keywords: hybrid model, structural equation modeling, artificial neural networks, eating behavior patterns

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538 Flood Prevention Strategy for Reserving Quality Ground Water Considering Future Population Growth in Kabul

Authors: Said Moqeem Sadat, Saito Takahiro, Inuzuka Norikazu, Sugiyama Ikuo

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Kabul city is the capital of Afghanistan with a population of about 4.0 million in 2009 and 6.5 million in 2025. It is geographically located in a narrow plain valley along the Kabul River and is surrounded by high mountains. Due to its sharp geological condition, the city has been suffering from floods caused by storm water and snow melting water in the rainy season. Meanwhile, potable water resources are becoming a critical issue as the underground water table is decreasing falling rapidly due to domestic usage, industrial and agricultural activities usage especially in the dry season. This paper focuses on flood water management in Kabul including suburban agricultural area considering not only for flood protection but also: 1. To reserve the quality underground water for the future population growth. 2. To irrigate farming area in dry season using storm water ponds in rainy season. 3. To discharge city contaminated flood water to the downstream safely using existing channels/new pipes. Cost and benefit is considered in this study to find out a suitable flood protection method both in rural area and city center from a view point of 1 to 3 mentioned above. In this analysis, cost mainly consists of lost opportunity to develop lands due to flood ponds in addition to construction and maintenance one including connecting channels for water collecting/discharging. Benefit mainly consists of damage reduction of flood loss due to counter measures (this is corresponding cost) in addition to the contribution to agricultural crops. As far as reservation of the ground water for the future city growth is concerned, future demand and supply are compared in case that the pumping amount is limited by this irrigation system.

Keywords: cost-benefit, hydrological modeling, water management, water quality

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537 The Anti-Glycation Effect of Sclerocarya birrea Stem-Bark Extracts and Their Ability to Break Existing Advanced Glycation End-Products Protein Cross-Links

Authors: O. I. Adeniran, M. A. Mogale

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Advanced glycation end-products (AGEs) have been implicated in the development and progression of vascular complications of diabetes mellitus and other age-related disease such as Alzheimer’s disease, heart diseases, stroke and limb amputation. The aim of the study was to determine the anti-glycation activity and AGE-cross-linking breaking ability of Sclerocarya birrea stem-bark extracts (SBSBETs). Hexane, ethyl acetate, methanol and water extracts of Sclerocarya birrea stem-bark and standard inhibitor, aminoguanidine (AG) were incubated with bovine serum albumin (BSA)-fructose mixture for 20 and 40 days. The amounts of total immunogenic AGEs (TIAGEs), fluorescent AGEs (FAGEs) and carboxymethyl lysine (CML) formed were determined and the percentage anti-glycation activity of each plant extract calculated. The ability of SBSBETs to break fructose-derived BSA-AGE-collagen cross-links was also investigated. All SBSBETs under investigation demonstrated less anti-glycation activity against TIAGE, FAGEs and CML than AG after 20 days incubation. After 40 days incubation, ethyl acetate, methanol and water SBSBETs demonstrated lower anti-glycation activity against TIAGEs than AG but exerted higher anti-glycation activity than AG against FAGEs. All SBSBETs except water demonstrated lower anti-glycation activity than AG against CML. With regard to the ability of SBSBETs to breakdown fructose-derived AGEs cross-links, the polar SBSBETs demonstrated higher ability to break AGE-cross-links than the non-polar ones. The results of this study may lead to the isolation of bio-active phyto-chemicals from SBSBETs that may be used for the prevention of vascular complication of diabetes.

Keywords: advanced glycation end-products, anti-glycation, cross-link breaking, Sclerocarrya birrea

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536 Nine Year Trend Analysis of Malaria in Kahsay Abera General Hospital Humera Town: Western Tigrai, Northern Ethiopia: A Retrospective Study

Authors: Getachew Belay, Getachew Kahsu, Brhane Berhe, Kebede Tesfay, Fitsum Mardu, Nigus Shishay, Hadush Negash, Aster Tsegaye

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Background: Malaria kills million people around the world, and it is still a serious public health problem in Ethiopia. Over the past years, the disease has been consistently reported as leading cause of outpatient visits, hospitalization and death in health facilities across the country. This study assessed malaria trend in Humera Town Kahsay Abera Hospital Tigrai region, Northern Ethiopia. Method: A Health facility retrospective cross sectional study was conducted in Kahsay Abera General Hospital from January 2011 to December 2019. Data of Malaria cases were reviewed from Health Management Information System with the help of experts in the office. The nine year data were extracted and analyzed using Excel by excluding those which lack demographic data. Result: A total of 36,604 smear positive malaria cases were confirmed in last nine years in the study area. Plasmodim falcifarum was the most prevalent reported species. Higher number of malaria cases were reported during October season.Males were more infected by the disese (63.1%) than females and males aged 15 years and above were the most iffected ones. The percentage proportion of P.falcifarum and P.vivax were 61.6% to 38.4%, respectively. There was a decreasing trend over the nine years following the peak in 2013. Conclusion: Malaria smear positivity, with highest cases being recorded in October, was declined over the nine years after peaking in 2013. Males aged 15 years and above were more affected, and P falciparum was the predominat species. Strengtheing the prevention and control activities is warranted in the study area.

Keywords: trend, malaria, kahsay abera general hospital, tigray, ethiopia

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535 Sodium-glucose Co-transporter-2 Inhibitors in Heart Failure with Mildly Reduced Reduced Ejection Fraction: Future Perspectives in Patients with Neoplasia

Authors: M. A. Munteanu, A. M. Lungu, A. I. Chivescu, V. Teodorescu, E. Tufanoiu, C. Nicolae, T. I. Nanea

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Introduction: Sodium-glucose co-transporter 2 inhibitors (SGLT2i), which were first developed as antidiabetic medications, have demonstrated numerous positive benefits on the cardiovascular system, especially in the prevention of heart failure (HF). HF is a challenging, multifaceted disease that needs all-encompassing therapy. It should not be viewed as a limited form of heart illness but rather as a systemic disease that leads to multiple organ failure and death. SGLT2i is an extremely effective tool for treating HF by using its pleiotropic effects. In addition to its use in patients with diabetes mellitus who are at high cardiovascular risk or who have already experienced a cardiovascular event, SGLT2i administration has been shown to have positive effects on a variety of HF manifestations and stages, regardless of the patient's presence of diabetes mellitus. Material and Methods: According to the guide, 110 patients (83 males and 27 females) with heart failure with mildly reduced ejection fraction (HFmrEF), with T2D and neoplasia, were enrolled in the prospective study. The structural and functional state of the left ventricle myocardium and ejection fraction was assessed through echocardiography. Patients were randomized to receive once-daily dapagliflozin 10 mg. Results: Patients with HFmrEF were divided into 3 subgroups according to age. 7% (8) patients aged < 45 years, 35% (28) patients aged between 46-59 years, and 58% (74) patients aged> 60 years. The most prevalent comorbidities were hypertension (43.1%), coronary heart disease (40%), and obesity (33.2%). Study drug discontinuation and serious adverse events were not frequent in the subgroups, in either men or women, until now. Conclusions: SGLT-2 inhibitors are a novel class of antidiabetic agents that have demonstrated positive efficacy and safety outcomes in the setting of HFmrEF. Until now, in our study, dapagliflozin was safe and well-tolerated irrespective of sex.

Keywords: diabetes mellitus type 2, Sodium-glucose co-transporters-2 inhibitors, heart failure, neoplasia

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534 Ecological Ice Hockey Butterfly Motion Assessment Using Inertial Measurement Unit Capture System

Authors: Y. Zhang, J. Perez, S. Marnier

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To date, no study on goaltending butterfly motion has been completed in real conditions, during an ice hockey game or training practice, to the author's best knowledge. This motion, performed to save score, is unnatural, intense, and repeated. The target of this research activity is to identify representative biomechanical criteria for this goaltender-specific movement pattern. Determining specific physical parameters may allow to will identify the risk of hip and groin injuries sustained by goaltenders. Four professional or academic goalies were instrumented during ice hockey training practices with five inertial measurement units. These devices were inserted in dedicated pockets located on each thigh and shank, and the fifth on the lumbar spine. A camera was also installed close to the ice to observe and record the goaltenders' activities, especially the butterfly motions, in order to synchronize the captured data and the behavior of the goaltender. Each data recorded began with a calibration of the inertial units and a calibration of the fully equipped goaltender on the ice. Three butterfly motions were recorded out of the training practice to define referential individual butterfly motions. Then, a data processing algorithm based on the Madgwick filter computed hip and knee joints joint range of motion as well as angular specific angular velocities. The developed algorithm software automatically identified and analyzed all the butterfly motions executed by the four different goaltenders. To date, it is still too early to show that the analyzed criteria are representative of the trauma generated by the butterfly motion as the research is only at its beginning. However, this descriptive research activity is promising in its ecological assessment, and once the criteria are found, the tools and protocols defined will allow the prevention of as many injuries as possible. It will thus be possible to build a specific training program for each goalie.

Keywords: biomechanics, butterfly motion, human motion analysis, ice hockey, inertial measurement unit

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533 Factors Influencing the Choice of Multi-Month Drug Dispensing Model Amongst Children and Adolescents Living with HIV (C/ALHIV) in Eswatini

Authors: Mbuso Siwela

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Background: The Sub-Saharan Africa region has the greatest number of people eligible to receive antiretroviral treatment (ART). Multi-month Drug dispensing (MMD) of antiretroviral treatment (ART) aims to reduce patient-related barriers to access long-term treatment and improve health system efficiency. In Eswatini, however, few children and adolescents are on MMD. Young Heroes is implementing an HIV program that aims to avert new HIV infections in children and youth and improve treatment outcomes for children and adolescents living with HIV (C/ALHIV: 0-19 Years) and OVC caregivers with HIV prevention and impact mitigation interventions that prevent new HIV infections and reduce vulnerability. Aim of the study: The study aimed to ascertain factors that are associated with the assignment of the MMD model on C/ALHIVs. Methodology: The project provides treatment adherence support through well-trained community cadres (Home Visitors - HVs) at both community and health facility levels. During door-to-door visits, HVs track all C/ALHIV enrolled in the project monthly and refer any who might have stopped or interrupted treatment. C/ALHIV with unsuppressed viral load is supported through case conferencing and teen clubs. A quantitative cross-sectional analysis was conducted using STATA for children and adolescents living with HIV enrolled in the project. Bivariate analysis was conducted, and the Logistic Regression model was used to ascertain the effects of duration on ART on the choice of MMD model. Results: Data for 544 C/ALHIV (0-19 Years) was analyzed in STATA. Results show a strong association between (duration on ART, Age, being in teen club) and enrolment in an MMD model. Duration on ART is a major predictor for the choice of MMD model at (95% CI: 0.0012905 – 0.0039812; P = <0.0001). C/ALHIV who have been on ART for less than a year are less likely to be on MMD. C/ALHIVs who are 1 or more years on ART are more likely to be in 3 months dispensing, while those who are 5 years or more are most likely to be in 6 months model.

Keywords: C/ALHIV, OVC, HIV, treatment

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