Search results for: common treatment

Authors: James Beauchemin

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Research indicates that college students are experiencing mental health challenges of greater severity, and an increased number of students are seeking help. Contributing to the compromised wellness of the college student population are the prevalence of unhealthy lifestyle habits and behaviors such as alcohol consumption, tobacco use, dietary concerns, risky sexual behaviors, and lack of physical activity. Alternative approaches are needed for this population that emphasize prevention and holistic lifestyle change that mitigate mental health and wellness challenges and alleviate strain on campus resources. This presentation will introduce a Solution-Focused Wellness (SFW) intervention model and examine wellness domains solution-focused strategies to promote personal well-being, and provide supporting research from multiple studies that illustrate intervention effectiveness with a collegiate population. Given the subjective and personal nature of wellness, a therapeutic approach that provides the opportunity for individuals to conceptualize and operationalize wellness themselves is critical to facilitating lasting wellness-based change. Solution-Focused Brief Therapy (SFBT) is a strength-based modality defined by its emphasis on constructing solutions rather than focusing on problems and the assumption that clients have the resources and capacity to change. SFBT has demonstrated effectiveness as a brief therapeutic intervention with the college population in groups and related to health and wellness. By integrating SFBT strategies with personal wellness, a brief intervention was developed to support college students in establishing lifestyles trends consistent with their conceptualizations of wellness. Research supports the effectiveness of a SFW model in improving college student wellness in both face-to-face and web-based formats. Outcomes of controlled and longitudinal studies will be presented, demonstrating significant improvements in perceptions of stress, life satisfaction, happiness, mental health, well-being, and resilience. Overall, there is compelling evidence that utilization of a Solution-Focused Brief Therapy approach with college students can help to improve personal wellness and establish healthy lifestyle trends, providing an effective prevention-focused strategy for college counseling centers and wellness centers to employ. Primary research objectives include: 1)establish an evidence-based approach to facilitating wellness pro motion among the college student population, 2) examine the effectiveness of a Solution-Focused Wellness (SFW) intervention model in decreasing stress, improving personal wellness, mental health, life satisfaction, and resiliency,3) investigate intervention impacts over time (e.g. 6-week post-intervention), and 4) demonstrate SFW intervention utility in wellness promotion and associated outcomes when compared with no-treatment control, and alternative intervention approaches.

Keywords: wellness, college students, solution-focused, prevention

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Authors: Rajkumar Ghosh

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The industrialization of coal mining and related activities has a significant impact on groundwater in the surrounding areas of the Damodar River. The Damodar River basin, located in eastern India, is known as the "Ruhr of India" due to its abundant coal reserves and extensive coal mining and industrial operations. One of the major consequences of collieries on groundwater is the contamination of water sources. Coal mining activities often involve the excavation and extraction of coal through underground or open-pit mining methods. These processes can release various pollutants and chemicals into the groundwater, including heavy metals, acid mine drainage, and other toxic substances. As a result, the quality of groundwater in the Damodar River region has deteriorated, making it unsuitable for drinking, irrigation, and other purposes. The high concentration of heavy metals, such as arsenic, lead, and mercury, in the groundwater has posed severe health risks to the local population. Prolonged exposure to contaminated water can lead to various health problems, including skin diseases, respiratory issues, and even long-term ailments like cancer. The contamination has also affected the aquatic ecosystem, harming fish populations and other organisms dependent on the river's water. Moreover, the excessive extraction of groundwater for industrial processes, including coal washing and cooling systems, has resulted in a decline in the water table and depletion of aquifers. This has led to water scarcity and reduced availability of water for agricultural activities, impacting the livelihoods of farmers in the region. Efforts have been made to mitigate these issues through the implementation of regulations and improved industrial practices. However, the historical legacy of coal industrialization continues to impact the groundwater in the Damodar River area. Remediation measures, such as the installation of water treatment plants and the promotion of sustainable mining practices, are essential to restore the quality of groundwater and ensure the well-being of the affected communities. In conclusion, the coal industrialization in the Damodar River surrounding has had a detrimental impact on groundwater. This research focuses on soil subsidence induced by the over-exploitation of ground water for dewatering open pit coal mines. Soil degradation happens in arid and semi-arid regions as a result of land subsidence in coal mining region, which reduces soil fertility. Depletion of aquifers, contamination, and water scarcity are some of the key challenges resulting from these activities. It is crucial to prioritize sustainable mining practices, environmental conservation, and the provision of clean drinking water to mitigate the long-lasting effects of collieries on the groundwater resources in the region.

Keywords: coal mining, groundwater, soil subsidence, water table, damodar river

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Authors: Masih Nikgou

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ICU nurses or intensive care nurses are highly specialized and trained healthcare personnel. These nurses provide nursing care for patients with life-threatening illnesses or conditions. They provide the experience, knowledge and specialized skills that patients need to survive and recover. Intensive care nurses (ICU) are trained to make momentary decisions and act quickly when the patient's condition changes. Their primary work environment is in the hospital in intensive care units. Typically, ICU patients require a high level of care. ICU nurses work in challenging and complex fields in their nursing profession. They have the primary duty of caring for and saving patients who are fighting for their lives. Intensive care (ICU) nurses are highly trained to provide exceptional care to patients who depend on 24/7 nursing care. A patient in the ICU is often equipped with a ventilator, intubated and connected to several life support machines and medical equipment. Intensive Care Nurses (ICU) have full expertise in considering all aspects of bringing back their patients. Some of the specific responsibilities of ICU nurses include (a) Assessing and monitoring the patient's progress and identifying any sudden changes in the patient's medical condition. (b) Administration of drugs intravenously by injection or through gastric tubes. (c) Provide regular updates on patient progress to physicians, patients, and their families. (d) According to the clinical condition of the patient, perform the approved diagnostic or treatment methods. (e) In case of a health emergency, informing the relevant doctors. (f) To determine the need for emergency interventions, evaluate laboratory data and vital signs of patients. (g) Caring for patient needs during recovery in the ICU. (h) ICU nurses often provide emotional support to patients and their families. (i) Regulating and monitoring medical equipment and devices such as medical ventilators, oxygen delivery devices, transducers, and pressure lines. (j) Assessment of pain level and sedation needs of patients. (k) Maintaining patient reports and records. As the name suggests, critical care nurses work primarily in ICU health care units. ICUs are completely healthy and have proper lighting with strict adherence to health and safety from medical centers. ICU nurses usually move between the intensive care unit, the emergency department, the operating room, and other special departments of the hospital. ICU nurses usually follow a standard shift schedule that includes morning, afternoon, and night schedules. There are also other relocation programs depending on the hospital and region. Nurses who are passionate about data and managing a patient's condition and outcomes typically do well as ICU nurses. An inquisitive mind and attention to processes are equally important. ICU nurses are completely compassionate and are not afraid to advocate for their patients and family members. who are distressed.

Keywords: nursing, intensive care unit, pediatric intensive care unit, mobile intensive care unit, surgical intensive care unite

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Authors: Jan Van Uden

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The paper reviews classical agency-theory and its contributions to the analysis of complex business negotiations and gives an approach for the modification of the basic agency-model in order to examine the negotiation specific dimensions of agency-problems. By illustrating fundamental potentials for the modification of agency-theory in context of business negotiations the paper highlights recent empirical research that investigates agent-based negotiations and inter-team constellations. A general theoretical analysis of complex negotiation would be based on a two-level approach. First, the modification of the basic agency-model in order to illustrate the organizational context of business negotiations (i.e., multi-agent issues, common-agencies, multi-period models and the concept of bounded rationality). Second, the application of the modified agency-model on complex business negotiations to identify agency-problems and relating areas of risk in the negotiation process. The paper is placed on the first level of analysis – the modification. The method builds on the one hand on insights from behavior decision research (BRD) and on the other hand on findings from agency-theory as normative directives to the modification of the basic model. Through neoclassical assumptions concerning the fundamental aspects of agency-relationships in business negotiations (i.e., asymmetric information, self-interest, risk preferences and conflict of interests), agency-theory helps to draw solutions on stated worst-case-scenarios taken from the daily negotiation routine. As agency-theory is the only universal approach able to identify trade-offs between certain aspects of economic cooperation, insights obtained provide a deeper understanding of the forces that shape business negotiation complexity. The need for a modification of the basic model is illustrated by highlighting selected issues of business negotiations from agency-theory perspective: Negotiation Teams require a multi-agent approach under the condition that often decision-makers as superior-agents are part of the team. The diversity of competences and decision-making authority is a phenomenon that overrides the assumptions of classical agency-theory and varies greatly in context of certain forms of business negotiations. Further, the basic model is bound to dyadic relationships preceded by the delegation of decision-making authority and builds on a contractual created (vertical) hierarchy. As a result, horizontal dynamics within the negotiation team playing an important role for negotiation success are therefore not considered in the investigation of agency-problems. Also, the trade-off between short-term relationships within the negotiation sphere and the long-term relationships of the corporate sphere calls for a multi-period perspective taking into account the sphere-specific governance-mechanisms already established (i.e., reward and monitoring systems). Within the analysis, the implementation of bounded rationality is closely related to findings from BRD to assess the impact of negotiation behavior on underlying principal-agent-relationships. As empirical findings show, the disclosure and reservation of information to the agent affect his negotiation behavior as well as final negotiation outcomes. Last, in context of business negotiations, asymmetric information is often intended by decision-makers acting as superior-agents or principals which calls for a bilateral risk-approach to agency-relations.

Keywords: business negotiations, agency-theory, negotiation analysis, interteam negotiations

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Authors: Majed Al Otaibi, Melissa Lessard-Beaudoin, Amel Loudghi, Raphael Chouinard-Watkins, Melanie Plourde, Frederic Calon, C. Alexandre Castellano, Stephen Cunnane, Helene Payette, Pierrette Gaudreau, Denis Gris, Rona K. Graham

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Introduction: Alzheimer disease (AD) is a chronic disorder that affects millions of individuals worldwide. Symptoms include memory dysfunction, and also alterations in attention, planning, language and overall cognitive function. Olfactory dysfunction is a common symptom of several neurological disorders including AD. Studying the mechanisms underlying the olfactory dysfunction may therefore lead to the discovery of potential biomarkers and/or treatments for neurodegenerative diseases. Objectives: To determine if olfactory dysfunction predicts future cognitive impairment in the aging population and to characterize the olfactory system in a murine model expressing a genetic factor of AD. Method: For the human study, quantitative olfactory tests (UPSIT and OMT) have been done on 93 subjects (aged 80 to 94 years) from the Quebec Longitudinal Study on Nutrition and Successful Aging (NuAge) cohort accepting to participate in the ORCA secondary study. The telephone Modified Mini Mental State examination (t-MMSE) was used to assess cognition levels, and an olfactory self-report was also collected. In a separate cohort, olfactory cortical volume was calculated using MRI results from healthy old adults (n=25) and patients with AD (n=18) using the AAL single-subject atlas and performed with the PNEURO tool (PMOD 3.7). For the murine study, we are using Western blotting, RT-PCR and immunohistochemistry. Result: Human Study: Based on the self-report, 81% of the participants claimed to not suffer from any problem with olfaction. However, based on the UPSIT, 94% of those subjects showed a poor olfactory performance and different forms of microsmia. Moreover, the results confirm that olfactory function declines with age. We also detected a significant decrease in olfactory cortical volume in AD individuals compared to controls. Murine study: Preliminary data demonstrate there is a significant decrease in expression levels of the proform of caspase-3 and the caspase substrate STK3, in the olfactory bulb of mice expressing human APOE4 compared with controls. In addition, there is a significant decrease in the expression level of the caspase-9 proform and caspase-8 active fragment. Analysis of the mature neuron marker, NeuN, shows decreased expression levels of both isoforms. The data also suggest that Iba-1 immunostaining is increased in the olfactory bulb of APOE4 mice compared to wild type mice. Conclusions: The activation of caspase-3 may be the cause of the decreased levels of STK3 through caspase cleavage and may play role in the inflammation observed. In the clinical study, our results suggest that seniors are unaware of their olfactory function status and therefore it is not sufficient to measure olfaction using the self-report in the elderly. Studying olfactory function and cognitive performance in the aging population will help to discover biomarkers in the early stage of the AD.

Keywords: Alzheimer's disease, APOE4, cognition, caspase, brain atrophy, neurodegenerative, olfactory dysfunction

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Authors: Elkington S. Mnguni

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Water and sanitation services in South Africa are characterized by both achievements and challenges. After the end of apartheid in 1994 the newly elected government faced the challenge of eradicating backlogs with respect to access to basic services, including water and sanitation. Capital investment made in the development of new water and sanitation infrastructure to provide basic services to previously disadvantaged communities has grown, to a certain extent, at the expense of investment in the operation and maintenance of new and existing infrastructure. Challenges resulting from aging infrastructure and poor plant performance highlight the need for investing in the maintenance, rehabilitation, and replacement of existing infrastructure to optimize the return on investment. Advanced water infrastructure asset management (IAM) is key to achieving adequate levels of service, particularly with regard to reliable and high quality drinking water supply, prevention of urban flooding, efficient use of natural resources and prevention of pollution and associated risks. Against this backdrop, this paper presents an appraisal of water and sanitation IAM systems in South Africa’s three utilities, being metropolitan cities in the Gauteng Province. About a quarter of the national population lives in the three rapidly urbanizing cities of Johannesburg, Ekurhuleni and Tshwane, located in a semi-arid region. A literature review has been done and field visits to some of the utility facilities are being conducted. Semi-structured interviews will be conducted with the three utilities. The following critical factors are being analysed in terms of compliance with the national Water Services IAM Strategy (2011) and other applicable legislation: asset registers; capacity of assets; current and predicted demand; funding availability / budget allocations; plans: operation & maintenance, renewal & replacement, and risk management; no-drop status (non-revenue water levels); blue drop status (water quality); green drop status (effluent quality); and skills availability. Some of the key challenges identified in the literature review include: funding constraints, Skills shortage, and wastewater treatment plants operating beyond their design capacities. These challenges will be verified during field visits and research interviews. Gaps between literature and practice will be identified and relevant recommendations made if necessary. The objective of this study is to contribute to the resolution of the challenges brought about by the backlogs in the operation and maintenance of water and sanitation assets in the country in general, and in the three cities in particular, thus improving the sustainability thereof.

Keywords: asset management, backlogs, levels of service, sustainability, water and sanitation infrastructure

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Authors: Maritza Estela Garay-Rodriguez, Mirella Gutierrez-Arzaluz, Miguel Torres-Rodriguez, Violeta Mugica-Alvarez

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Arsenic is an element present in the earth's crust and is dispersed in the environment through natural processes and some anthropogenic activities. Naturally released into the environment through the weathering and erosion of sulphides mineral, some activities such as mining, the use of pesticides or wood preservatives potentially increase the concentration of arsenic in air, water, and soil. The natural arsenic release of a geological material is a threat to the world's drinking water sources. In aqueous phase is found in inorganic form, as arsenate and arsenite mainly, the contamination of groundwater by salts of this element originates what is known as endemic regional hydroarsenicism. The International Agency for Research on Cancer (IARC) categorizes the inorganic As within group I, as a substance with proven carcinogenic action for humans. It has been found the presence of As in groundwater in several countries such as Argentina, Mexico, Bangladesh, Canada and the United States. Regarding the concentration of arsenic in drinking water according to the World Health Organization (WHO) and the Environmental Protection Agency (EPA) establish maximum concentrations of 10 μg L⁻¹. In Mexico, in some states as Hidalgo, Morelos and Michoacán concentrations of arsenic have been found in bodies of water around 1000 μg L⁻¹, a concentration that is well above what is allowed by Mexican regulations with the NOM-127- SSA1-1994 that establishes a limit of 25 μg L⁻¹. Given this problem in Mexico, this research proposes the use of a natural Mexican zeolite (clinoptilolite type) native to the district of Etla in the central valley region of Oaxaca, as an adsorbent for the removal of arsenic. The zeolite was subjected to a conditioning with iron oxide by the precipitation-impregnation method with 0.5 M iron nitrate solution, in order to increase the natural adsorption capacity of this material. The removal of arsenic was carried out in a column with a fixed bed of conditioned zeolite, since it combines the advantages of a conventional filter with those of a natural adsorbent medium, providing a continuous treatment, of low cost and relatively easy to operate, for its implementation in marginalized areas. The zeolite was characterized by XRD, SEM/EDS, and FTIR before and after the arsenic adsorption tests, the results showed that the modification methods used are adequate to prepare adsorbent materials since it does not modify its structure, the results showed that with a particle size of 1.18 mm, an initial concentration of As (V) ions of 1 ppm, a pH of 7 and at room temperature, a removal of 98.7% was obtained with an adsorption capacity of 260 μg As g⁻¹ zeolite. The results obtained indicated that the conditioned zeolite is favorable for the elimination of arsenate in water containing up to 1000 μg As L⁻¹ and could be suitable for removing arsenate from pits of water.

Keywords: adsorption, arsenic, iron conditioning, natural zeolite

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Authors: Catherine S. Fichten, Tali Heiman, Mary Jorgensen, Mai Nhu Nguyen, Rhonda Amsel, Dorit Olenik-Shemesh

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The study examined Canadian and Israeli students' perceptions related to their intention to graduate from their program of studies. Canada and Israel are dissimilar in many ways that affect education, including language and alphabet. In addition, the postsecondary education systems differ. For example, in some parts of Canada (e.g., in Quebec, Canada’s 2nd largest province), students matriculate after 11 years of high school; in Israel, this typically occurs after 12 years. In addition, Quebec students attend two compulsory years of junior college before enrolling in a three-year university Bachelor program; in Israel students enroll in a three-year Bachelor program directly after matriculation. In addition, Israeli students typically enroll in the army shortly after high school graduation; in Canada, this is not the case. What the two countries do have in common is concern about the success of postsecondary students with disabilities. The present study was based on Ajzen’s Theory of Planned Behavior (TPB); the model suggests that behavior is influenced by Intention to carry it out. This, in turn, is predicted by the following correlated variables: Perceived Behavioral Control (i.e., ease or difficulty enacting the behavior - in this case graduation), Subjective Norms (i.e., perceived social/peer pressure from individuals important in the student’s life), and Attitude (i.e., positive or negative evaluation of graduation). A questionnaire was developed to test the TPB in previous Canadian studies and administered to 845 Canadian college students (755 nondisabled, 90 with LD/ADHD) who had completed at least one semester of studies) and to 660 Israeli university students enrolled in a Bachelor’s program (537 nondisabled, 123 with LD/ADHD). Because Israeli students were older than Canadian students we covaried age in SPSS-based ANOVA comparisons and included it in regression equations. Because females typically have better academic outcomes than males, gender was included in all analyses. ANOVA results indicate only a significant gender effect for Intention to graduate, with females having higher scores. Four stepwise regressions were conducted, with Intention to graduate as the predicted variable, and Gender and the three TPB predictors as independent variables (separate analyses for Israeli and Canadian samples with and without LD/ADHD). Results show that for samples with LD/ADHD, although Gender and Age were not significant predictors, the TPB predictors were, with all three TPB predictors being significant for the Canadian sample (i.e., Perceived Behavioral Control, Subjective Norms, Attitude, R2=.595), and two of the three (i.e., Perceived Behavioral Control, Subjective Norms) for the Israeli sample (R2=.528). For nondisabled students, the results for both countries show that all three TPB predictors were significant along with Gender: R2=.443 for Canada and R2=.332 for Israel; age was not significant. Our findings show that despite vast differences between our Canadian and Israeli samples, Intention to graduate was related to the three TPB predictors. This suggests that our TPB measure is valid for diverse samples and countries that it can be used as a quick, inexpensive way to predict graduation rates, and that strengthening the three predictor variables may result in higher graduation rates.

Keywords: disability, higher education, students, theory of planned behavior

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Authors: Roberta Pecoraro

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The focus of this work was to investigate the potential toxic effect of titanium dioxide-reduced graphene oxide (TiO₂-rGO) nanocomposites on nauplii of microcrustacean Artemia sp. In order to assess the nanocomposite’s toxicity, a short-term test was performed by exposing nauplii to solutions containing TiO₂-rGO. To prepare titanium dioxide-reduced graphene oxide (TiO₂-rGO) nanocomposites, a green procedure based on solar photoreduction was proposed; it allows to obtain the photocatalysts by exploiting the photocatalytic properties of titania activated by the solar irradiation in order to avoid the high temperatures and pressures required for the standard hydrothermal synthesis. Powders of TiO₂-rGO supplied by the Department of Chemical Sciences (University of Catania) are indicated as TiO₂-rGO at 1% and TiO₂-rGO at 2%. Starting from a stock solution (1mg rGO-TiO₂/10 ml ASPM water) of each type, we tested four different concentrations (serial dilutions ranging from 10⁻¹ to 10⁻⁴ mg/ml). All the solutions have been sonicated for 12 min prior to use. Artificial seawater (called ASPM water) was prepared to guarantee the hatching of the cysts and to maintain nauplii; the durable cysts used in this study, marketed by JBL (JBL GmbH & Co. KG, Germany), were hydrated with ASPM water to obtain nauplii (instar II-III larvae). The hatching of the cysts was carried out in the laboratory by immersing them in ASPM water inside a 500 ml beaker and keeping them constantly oxygenated thanks to an aerator for the insufflation of microbubble air: after 24-48 hours, the cysts hatched, and the nauplii appeared. The nauplii in the second and third stages of development were collected one-to-one, using stereomicroscopes, and transferred into 96-well microplates where one nauplius per well was added. The wells quickly have been filled with 300 µl of each specific concentration of the solution used, and control samples were incubated only with ASPM water. Replication was performed for each concentration. Finally, the microplates were placed on an orbital shaker, and the tests were read after 24 and 48 hours from inoculating the solutions to assess the endpoint (immobility/death) for the larvae. Nauplii that appeared motionless were counted as dead, and the percentages of mortality were calculated for each treatment. The results showed a low percentage of immobilization both for TiO₂-rGO at 1% and TiO₂-rGO at 2% for all concentrations tested: for TiO₂-rGO at 1% was below 12% after 24h and below 15% after 48h; for TiO₂-rGO at 2% was below 8% after 24h and below 12% after 48h. According to other studies in the literature, the results have not shown mortality nor toxic effects on the development of larvae after exposure to rGO. Finally, it is important to highlight that the TiO₂-rGO catalysts were tested in the solar photodegradation of a toxic herbicide (2,4-Dichlorophenoxyacetic acid, 2,4-D), obtaining a high percentage of degradation; therefore, this alternative approach could be considered a good strategy to obtain performing photocatalysts.

Keywords: Nauplii, photocatalytic properties, reduced GO, short-term toxicity test, titanium dioxide

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Authors: Padma Chutoo, Elena Kulinskaya, Ilyas Bakbergenuly, Nicholas Steel, Dmitri Pchejetski

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Stroke is associated with a significant risk of morbidity and mortality. There is scarcity of research on the long-term survival after first-ever ischaemic stroke (IS) events in England with regards to effects of different medical therapies and comorbidities. The objective of this study was to model the all-cause mortality after an IS diagnosis in the adult population of England. Using a retrospective case-control design, we extracted the electronic medical records of patients born prior to or in year 1960 in England with a first-ever ischaemic stroke diagnosis from January 1986 to January 2017 within the Health and Improvement Network (THIN) database. Participants with a history of ischaemic stroke were matched to 3 controls by sex and age at diagnosis and general practice. The primary outcome was the all-cause mortality. The hazards of the all-cause mortality were estimated using a Weibull-Cox survival model which included both scale and shape effects and a shared random effect of general practice. The model included sex, birth cohort, socio-economic status, comorbidities and medical therapies. 20,250 patients with a history of IS (cases) and 55,519 controls were followed up to 30 years. From 2008 to 2015, the one-year all-cause mortality for the IS patients declined with an absolute change of -0.5%. Preventive treatments to cases increased considerably over time. These included prescriptions of statins and antihypertensives. However, prescriptions for antiplatelet drugs decreased in the routine general practice since 2010. The survival model revealed a survival benefit of antiplatelet treatment to stroke survivors with hazard ratio (HR) of 0.92 (0.90 – 0.94). IS diagnosis had significant interactions with gender and age at entry and hypertension diagnosis. IS diagnosis was associated with high risk of all-cause mortality with HR= 3.39 (3.05-3.72) for cases compared to controls. Hypertension was associated with poor survival with HR = 4.79 (4.49 - 5.09) for hypertensive cases relative to non-hypertensive controls, though the detrimental effect of hypertension has not reached significance for hypertensive controls, HR = 1.19(0.82-1.56). This study of English primary care data showed that between 2008 and 2015, the rates of prescriptions of stroke preventive treatments increased, and a short-term all-cause mortality after IS stroke declined. However, stroke resulted in poor long-term survival. Hypertension, a modifiable risk factor, was found to be associated with poor survival outcomes in IS patients. Antiplatelet drugs were found to be protective to survival. Better efforts are required to reduce the burden of stroke through health service development and primary prevention.

Keywords: general practice, hazard ratio, health improvement network (THIN), ischaemic stroke, multiple imputation, Weibull-Cox model.

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Authors: Chinasa U. Imo, Queen Chikwendu, Jonathan Ajuma, Mario Banuelos

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Background: Sociocultural norms primarily influence the health-seeking behavior of populations in rural communities. In the Nkporo community, Abia State, Nigeria, their sociocultural perception of diseases runs counter to biomedical definitions, wherein they rely heavily on traditional medicine and practices. In a state where birth asphyxia and sepsis account for the significant causes of death for neonates, malaria leads to the causes of other mortalities, followed by common preventable diseases such as diarrhea, pneumonia, acute respiratory tract infection, malnutrition, and HIV/AIDS. Most local mothers attribute their health conditions and that of their children to witchcraft attacks, the hand of God, and ancestral underlining. This influences how they see antenatal and postnatal care, choice of place of accessing care and birth delivery, response to children's illnesses, immunization, and nutrition. Method: To implement a community health improvement program, we adopted an asset-based community development model to address health's normative and social determinants. The first step was to use a qualitative approach to conduct a community health needs baseline assessment, involving focus group discussions with twenty-five (25) youths aged 18-25, semi-structured interviews with ten (10) officers-in-charge of primary health centers, eight (8) ward health committee members, and nine (9) community leaders. Secondly, we designed an intervention program. Going forward, we will proceed with implementing and evaluating this program. Result: The priority needs identified by the communities were malaria, lack of clean drinking water, and the need for behavioral change information. The study also highlighted the significant influence of youths on their peers, family, and community as caregivers and information interpreters. Based on the findings, the NGO SieDi-Hub collaborated with the Abia State Ministry of Health, the State Primary Healthcare Agency, and Empower Next Generations to design a one-year "Community Health Youth Champions Pilot Program." Twenty (20) youths in the community were trained and equipped to champion a participatory approach to bridging the gap between access and delivery of primary healthcare, to adjust sociocultural norms to improve health equity for people in Nkporo community – with limited education, lack of access to health information, and quality healthcare facilities using an innovative community-led improvement approach. Conclusion: Youths play a vital role in achieving health equity, being a vulnerable population with significant influence. To ensure effective primary healthcare, strategies must include cultural humility. The asset-based community development model offers valuable tools, and this article will share ongoing lessons from the intervention's behavioral change strategies with young people.

Keywords: asset-based community development, community health, primary health systems strengthening, youth empowerment

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Authors: Chien-Chun Huang, P. W. Yuan

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Banana is one of the important fruits which constitute a valuable source of energy, vitamins and minerals and an important food component throughout the world. The fruit ripening and maturity standards vary from country to country depending on the expected shelf life of market. During ripening there are changes in appearance, texture and chemical composition of banana. The changes of component of banana during ethylene-induced ripening are categorized as nutritive values and commercial utilization. The objectives of this study were to investigate the changes of chemical composition and physicochemical properties of banana during ethylene-induced ripening. Green bananas were harvested and ripened by ethylene gas at low temperature (15℃) for seven stages. At each stage, banana was sliced and freeze-dried for banana flour preparation. The changes of total starch, resistant starch, chemical compositions, physicochemical properties, activity of amylase, polyphenolic oxidase (PPO) and phenylalanine ammonia lyase (PAL) of banana were analyzed each stage during ripening. The banana starch was isolated and analyzed for gelatinization properties, pasting properties and microscopic appearance each stage of ripening. The results indicated that the highest total starch and resistant starch content of green banana were 76.2% and 34.6%, respectively at the harvest stage. Both total starch and resistant starch content were significantly declined to 25.3% and 8.8%, respectively at the seventh stage. Soluble sugars content of banana increased from 1.21% at harvest stage to 37.72% at seventh stage during ethylene-induced ripening. Swelling power of banana flour decreased with the progress of ripening stage, but solubility increased. These results strongly related with the decreases of starch content of banana flour during ethylene-induced ripening. Both water insoluble and alcohol insoluble solids of banana flour decreased with the progress of ripening stage. Both activity of PPO and PAL increased, but the total free phenolics content decreased, with the increases of ripening stages. As ripening stage extended, the gelatinization enthalpy of banana starch significantly decreased from 15.31 J/g at the harvest stage to 10.55 J/g at the seventh stage. The peak viscosity and setback increased with the progress of ripening stages in the pasting properties of banana starch. The highest final viscosity, 5701 RVU, of banana starch slurry was found at the seventh stage. The scanning electron micrograph of banana starch showed the shapes of banana starch appeared to be round and elongated forms, ranging in 10-50 μm at the harvest stage. As the banana closed to ripe status, some parallel striations were observed on the surface of banana starch granular which could be caused by enzyme reaction during ripening. These results inferred that the highest resistant starch was found in the green banana could be considered as a potential application of healthy foods. The changes of chemical composition and physicochemical properties of banana could be caused by the hydrolysis of enzymes during the ethylene-induced ripening treatment.

Keywords: maturation of banana, appearance, texture, soluble sugars, resistant starch, enzyme activities, physicochemical properties of banana starch

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Authors: Dina Farran, Mark Ashworth, Fiona Gaughran

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Atrial fibrillation (AF), the most prevalent cardiac arrhythmia, is associated with an increased risk of stroke, contributing to heart failure and death. In this project, we aim to improve patient safety by screening for stroke risk among people with AF and co-morbid mental illness. To do so, we started by conducting a systematic review and meta-analysis on prevalence, management, and outcomes of AF in people with Serious Mental Illness (SMI) versus the general population. We then evaluated oral anticoagulation (OAC) prescription trends in people with AF and co-morbid SMI in King’s College Hospital. We also evaluated the association between mental illness severity and OAC prescription in eligible patients in South London and Maudsley (SLaM) NHS Foundation Trust. Next, we implemented an electronic clinical decision support system (eCDSS) consisting of a visual prompt on patient electronic Personal Health Records to screen for AF-related stroke risk in three Mental Health of Older Adults wards at SLaM. Finally, we assessed the feasibility and acceptability of the eCDSS by qualitatively investigating clinicians’ perspectives of the potential usefulness of the eCDSS (pre-intervention) and their experiences and their views regarding its impact on clinicians and patients (post-intervention). The systematic review showed that people with SMI had low reported rates of AF. AF patients with SMI were less likely to receive OAC than the general population. When receiving warfarin, people with SMI, particularly bipolar disorder, experienced poor anticoagulation control compared to the general population. Meta-analysis showed that SMI was not significantly associated with an increased risk of stroke or major bleeding when adjusting for underlying risk factors. The main findings of the first observational study were that among AF patients having a high stroke risk, those with co-morbid SMI were less likely than non-SMI to be prescribed any OAC, particularly warfarin. After 2019, there was no significant difference between the two groups. In the second observational study, patients with AF and co-morbid SMI were less likely to be prescribed any OAC compared to those with dementia, substance use disorders, or common mental disorders, adjusting for age, sex, stroke, and bleeding risk scores. Among AF patients with co-morbid SMI, warfarin was less likely to be prescribed to those having alcohol or substance dependency, serious self-injury, hallucinations or delusions, and activities of daily living impairment. In the intervention, clinicians were asked to confirm the presence of AF, clinically assess stroke and bleeding risks, record risk scores in clinical notes, and refer patients at high risk of stroke to OAC clinics. Clinicians reported many potential benefits for the eCDSS, including improving clinical effectiveness, better identification of patients at risk, safer and more comprehensive care, consistency in decision making and saving time. Identified potential risks included rigidity in decision-making, overreliance, reduced critical thinking, false positive recommendations, annoyance, and increased workload. This study presents a unique opportunity to quantify AF patients with mental illness who are at high risk of severe outcomes using electronic health records. This has the potential to improve health outcomes and, therefore patients' quality of life.

Keywords: atrial fibrillation, stroke, mental health conditions, electronic clinical decision support systems

Procedia PDF Downloads 44

Authors: Byron Baron

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Typical of the Mediterranean region, the Maltese islands exhibit calcareous soils containing low organic carbon content and high salinity, in addition to being relatively shallow. This has lead to the common practice of applying copious amounts of artificial fertilisers as well as other chemical inputs, together with the use of ground water having high salinity. Such intensive agricultural activities, over a prolonged time period, on such land has lead further to the loss of any soil fertility, together with direct negative impacts on the quality of fresh water reserves and the local ecosystem. The aim of this study was to investigate whether the natural resources on the island would be sufficient to apply ecological intensification i.e. the use of natural processes to replace anthropological inputs without any significant loss in food production. This was implementing through a sustainable agricultural system based on permaculture practices. Ecological intensification following permaculture principles was implemented for two years in order to capture the seasonal changes in duplicate. The areas dedicated to wild plants were only trimmed back to avoid excessive seeding but never mowing. A number of local staple crops were grown throughout this period, also in duplicate. Concomitantly, a number of practices were implemented following permaculture principles such as reducing land tilling, applying only natural fertiliser, mulching, monitoring of soil parameters using sensors, no use of herbicides or pesticides, and precision irrigation linked to a desalination system. Numerous environmental parameters were measured at regular intervals so as to quantify any improvements in ecological conditions. Crop output was also measured as kilos of produce per area. The results clearly show that over the two year period, the variety of wild plant species increased, the number of visiting pollinators increased, there were no pest infestations (although an increase in the number of pests was observed), and a slight improvement in overall soil health was also observed. This was obviously limited by the short duration of the testing implementation. Dedicating slightly less than 15% of total land area to wild plants in the form of borders around plots of crops assisted pollination and provided a foraging area for gleaning bats (measured as an increased number of feeding buzzes) whilst not giving rise to any pest infestations and no apparent yield losses or ill effects to the crops. Observed increases in crop yields were not significant. The study concluded that with the right support for the initial establishment of a healthy ecosystem and controlled intervention, the available natural resources on the island can substantially improve the condition of the local agricultural land area, resulting is a more prolonged economical output with greater ecological sustainability. That being said, more comprehensive and long-term monitoring is required in order to fully validate these results and design a sustainable agriculture system that truly achieves the best outcome for the Maltese context.

Keywords: ecological intensification, soil health, sustainable agriculture, permaculture

Procedia PDF Downloads 63

Authors: Vaiddehi Bansal, Laura Hinson, Mayumi Rezwan, Erin Leasure, Mithila Iyer, Connor Roth, Poulomi Pal, Kareem Kysia

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As digital usage becomes increasingly ubiquitous worldwide, technology-facilitated gender-based violence (GBV) has garnered increasing attention in the recent years, especially during the COVID-19 pandemic. This form of violence is defined as “action by one or more people that harms others based on their sexual or gender identity or by enforcing harmful gender norms. This action is carried out using the internet and/or mobile technology that harms others based on their sexual or gender identity or by enforcing harmful gender norms”.Common forms of technology-facilitated GBV include cyberstalking, cyberbullying, sexual harassment, image-based abuse, doxing, hacking, gendertrolling, hate speech, and impersonation. Most literature on this pervasive yet complex issue has emerged from high-income countries, and few studies comprehensively summarize its prevalence, manifestations, and implications. This rigorous scoping review examines the evidence base of this phenomenon in low and middle-income countries across Asia, summarizing trends and gaps to inform actionable recommendations. The research team developed search terms to conduct a comprehensive search of peer-reviewed and grey literature. Query results were eligible for inclusion if they were published in English between 2006-2021 and with an explicit emphasis on technology-facilitated violence, gender, and the countries of interest in the Asia region. Title, abstracts, and full-texts were independently screened by two reviewers based on inclusion criteria, and data was extracted through deductive coding. Of 2,042 articles screened, 97 met inclusion criteria. The review revealed a gap in the evidence-base in Central Asia and the Pacific Islands. Findings across South and Southeast Asia indicate that technology-facilitated GBV comprises various forms of abuse, violence, and harassment that are largely shaped by country-specific societal norms and technological landscapes. The literature confirms that women, girls, and sexual minorities, especially those with intersecting marginalized identities, are often more vulnerable to experiencing online violence. Cultural norms and patriarchal structures tend to stigmatize survivors, limiting their ability to seek social and legal support. Survivors are also less likely to report their experience due to barriers such as lack of awareness of reporting mechanisms, the perception that digital platforms will not address their complaints, and cumbersome reporting systems. The COVID-19 pandemic has further exacerbated perpetration and strained support mechanisms. Prevalence varies by the form of violence but is difficult to estimate accurately due to underreporting and disjointed, outdated, or non-existent legal definitions. Addressing technology-facilitated GBV in Asia requires collective action from multiple actors, including government authorities, technology companies, digital and feminist movements, NGOs, and researchers.

Keywords: gender-based violence, technology, online sexual harassment, image-based abuse

Procedia PDF Downloads 129

Authors: Sergio A. Bernal-Chavez, Sergio Alcalá-Alcalá, Doris A. Cerecedo-Mercado, Adriana Ganem-Rondero

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The prevalence of people with chronic wounds has increased dramatically by many factors including smoking, obesity and chronic diseases, such as diabetes, that can slow the healing process and increase the risk of becoming chronic. Because of this situation, the improvement of chronic wound treatments is a necessity, which has led to the scientific community to focus on improving the effectiveness of current therapies and the development of new treatments. The wound formation is a physiological complex process, which is characterized by an inflammatory stage with the presence of proinflammatory cells that create a proteolytic microenvironment during the healing process, which includes the degradation of important growth factors and cytokines. This decrease of growth factors and cytokines provides an interesting strategy for wound healing if they are administered externally. The use of nanometric drug delivery systems, such as polymer nanoparticles (NP), also offers an interesting alternative around dermal systems. An interesting strategy would be to propose a formulation based on a thermosensitive hydrogel loaded with polymeric nanoparticles that allows the inclusion and application of a platelet lysate (PL) on damaged skin, with the aim of promoting wound healing. In this work, NP were prepared by a double emulsion-solvent evaporation technique, using polylactic-co-glycolic acid (PLGA) as biodegradable polymer. Firstly, an aqueous solution of PL was emulsified into a PLGA organic solution, previously prepared in dichloromethane (DCM). Then, this disperse system (W/O) was poured into a polyvinyl alcohol (PVA) solution to get the double emulsion (W/O/W), finally the DCM was evaporated by magnetic stirring resulting in the NP formation containing PL. Once the NP were obtained, these systems were characterized by morphology, particle size, Z-potential, encapsulation efficiency (%EE), physical stability, infrared spectrum, calorimetric studies (DSC) and in vitro release profile. The optimized nanoparticles were included in a thermosensitive gel formulation of Pluronic® F-127. The gel was prepared by the cold method at 4 °C and 20% of polymer concentration. Viscosity, sol-gel phase transition, time of no flow solid-gel at wound temperature, changes in particle size by temperature-effect using dynamic light scattering (DLS), occlusive effect, gel degradation, infrared spectrum and micellar point by DSC were evaluated in all gel formulations. PLGA NP of 267 ± 10.5 nm and Z-potential of -29.1 ± 1 mV were obtained. TEM micrographs verified the size of NP and evidenced their spherical shape. The %EE for the system was around 99%. Thermograms and in infrared spectra mark the presence of PL in NP. The systems did not show significant changes in the parameters mentioned above, during the stability studies. Regarding the gel formulation, the transition sol-gel occurred at 28 °C with a time of no flow solid-gel of 7 min at 33°C (common wound temperature). Calorimetric, DLS and infrared studies corroborated the physical properties of a thermosensitive gel, such as the micellar point. In conclusion, the thermosensitive gel described in this work, contains therapeutic amounts of PL and fulfills the technological properties to be used in damaged skin, with potential application in wound healing and tissue regeneration.

Keywords: growth factors, polymeric nanoparticles, thermosensitive hydrogels, tissue regeneration

Procedia PDF Downloads 169

Authors: Jennifer Buz, Alvin Spivey

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The most common greenhouse gas emitted through human activities, carbon dioxide (CO2), is naturally consumed by plants during photosynthesis. This process is actively being monetized by companies wishing to offset their carbon dioxide emissions. For example, companies are now able to purchase protections for vegetated land due-to-be clear cut or purchase barren land for reforestation. Therefore, by actively preventing the destruction/decay of plant matter or by introducing more plant matter (reforestation), a company can theoretically offset some of their emissions. One of the biggest issues in the carbon credit market is validating and verifying carbon offsets. There is a need for a system that can accurately and frequently ensure that the areas sold for carbon credits have the vegetation mass (and therefore for carbon offset capability) they claim. Traditional techniques for measuring vegetation mass and determining health are costly and require many person-hours. Orbital Sidekick offers an alternative approach that accurately quantifies carbon mass and assesses vegetation health through satellite hyperspectral imagery, a technique which enables us to remotely identify material composition (including plant species) and condition (e.g., health and growth stage). How much carbon a plant is capable of storing ultimately is tied to many factors, including material density (primarily species-dependent), plant size, and health (trees that are actively decaying are not effectively storing carbon). All of these factors are capable of being observed through satellite hyperspectral imagery. This abstract focuses on speciation. To build a species classification model, we matched pixels in our remote sensing imagery to plants on the ground for which we know the species. To accomplish this, we collaborated with the researchers at the Teakettle Experimental Forest. Our remote sensing data comes from our airborne “Kato” sensor, which flew over the study area and acquired hyperspectral imagery (400-2500 nm, 472 bands) at ~0.5 m/pixel resolution. Coverage of the entire teakettle experimental forest required capturing dozens of individual hyperspectral images. In order to combine these images into a mosaic, we accounted for potential variations of atmospheric conditions throughout the data collection. To do this, we ran an open source atmospheric correction routine called ISOFIT1 (Imaging Spectrometer Optiman FITting), which converted all of our remote sensing data from radiance to reflectance. A database of reflectance spectra for each of the tree species within the study area was acquired using the Teakettle stem map and the geo-referenced hyperspectral images. We found that a wide variety of machine learning classifiers were able to identify the species within our images with high (>95%) accuracy. For the most robust quantification of carbon mass and the best assessment of the health of a vegetated area, speciation is critical. Through the use of high resolution hyperspectral data, ground-truth databases, and complex analytical techniques, we are able to determine the species present within a pixel to a high degree of accuracy. These species identifications will feed directly into our carbon mass model.

Keywords: hyperspectral, satellite, carbon, imagery, python, machine learning, speciation

Procedia PDF Downloads 122

Authors: D. N. Kambrekar, S. B. Jagginavar, J. Aruna

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Grape stem borer, Celosterna scrabrator is an important production constraint in grapes in India. Hitherto this pest was a severe menace only on the aged and unmanaged fields but during the recent past it has also started damaging the newly established fields. In India, since Karnataka, Andra Pradesh, Tamil Nadu and Maharashtra are the major grape production states, the incidence of stem borer is also restricted and severe in these states. The grubs of the beetle bore in to the main stem and even the branches, which affect the translocation of nutrients to the areal parts of the plant. Since, the grubs bore inside the stem, the chewed material along with its excreta is discharged outside the holes and the frass is found on the ground just below the bored holes. The portion of vines above the damaged part has a sticky appearance. The leaves become pale yellow which looks like a deficiency of micronutrients. The leaves ultimately dry and drop down. The status of the incidence of the grape stem borer in different grape growing districts of Northern Karnataka was carried out during three years. In each taluka five locations were surveyed for the incidence of grape stem borer. Further, the experiment on management of stem borer was carried out in the grape gardens of Vijayapur districts under farmers field during three years. Stem borer infested plants that show live holes were selected per treatments and it was replicated three times. Live and dead holes observed during pre-treatment were closely monitored and only plants with live holes were selected and tagged. Different doses of chlorantraniliprole 0.4% GR were incorporated into the soil around the vine basins near root zone surrounded to trunk region by removing soils up to 5-10 cm with a peripheral distance of 1 to 1.5 feet from the main trunk where feeder roots are present. Irrigation was followed after application of insecticide for proper incorporation of the test chemical. The results indicated that there was sever to moderate incidence of the stem borer in all the grape growing districts of northern Karnataka. Maximum incidence was recorded in Belagavi (11 holes per vine) and minimum was in Gadag district (8.5 holes per vine). The investigations carried out to study the efficacy of chlorantraniliprole on grape stem borer for successive three years under farmers field indicated that chlorantraniliprole @ 15g/vine applied just near the active root zone of the plant followed by irrigation has successfully managed the pest. The insecticide has translocated to all the parts of the plants and thereby stopped the activity of the pest which has resulted in to better growth of the plant and higher berry yield compared to other treatments under investigation. Thus, chlorantraniliprole 0.4 GR @ 15g/vine can be effective means in managing the stem borer.

Keywords: chlorantraniliprole, grape stem borer, Celosterna scrabrator, management

Procedia PDF Downloads 440

Authors: Bartosz Piechowicz, Stanislaw Sadlo, Przemyslaw Grodzicki, Magdalena Podbielska

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Apples are popular fruits. They are eaten freshly and/or after processing. For instance Golden Delicious is an apple variety commonly used in production of foods for babies and toddlers. It is no wonder that complex analyses of the pesticide residue levels in those fruits have been carried out since eighties, and continued for the next years up to now. The results obtained were presented, usually as a teamwork, at the scientific sessions organised by the (IOR) Institute of Plant Protection-National Research Institute in Poznań and published in Scientific Works of the Institute (now Progress in Plant Protection/ Postępy w Ochronie Roślin) or Journal of Plant Protection Research, and in many non-periodical publications. These reports included studies carried out by IOR Laboratories in Poznań, Sośnicowice, Rzeszów and Bialystok. First detailed studies on the presence of pesticide residues in apple fruits by the laboratory in Rzeszów were published in 1991 in the article entitled 'The presence of pesticides in apples of late varieties from the area of south-eastern Poland in the years 1986-1989', in Annals of National Institute of Hygiene in Warsaw. These surveys gave the scientific base for business contacts between the Polish company Alima and the American company Gerber. At the beginning of XXI century, in Poland, systematic and complex studies on the deposition of pesticide residues in apples were initiated. First of all, the levels of active ingredients of plant protection products applied against storage diseases at 2-3 weeks before the harvest were determined. It is known that the above mentioned substances usually generate the highest residue levels. Also, the assessment of the fungicide residues in apples during their storage in controlled atmosphere and during their processing was carried out. Taking into account the need of actualisation the Maximum Residue Levels of pesticides, in force in Poland and in other European countries, and rationalisation of the ways of their determination, a lot of field tests on the behaviour of more important fungicides on the mature fruits just before their harvesting, were carried out. A rate of their disappearance and mathematical equation that showed the relationship between the residue level of any substance and the used dose, have been determined. The two parameters have allowed to evaluate the Maximum Residue Levels (MRLs) of pesticides, which were in force at that time, and to propose a coherent model of their determination in respect to the new substances. The obtained results were assessed in terms of the health risk for adult consumers and children, and to such determination of terms of treatment that mature apples could meet the rigorous level of 0.01 mg/kg.

Keywords: apple, disappearance, health risk, MRL, pesticide residue, research

Procedia PDF Downloads 272

Authors: Ocsana Opris, Ildiko Lung, Maria L. Soran, Alexandra Ciorita, Lucian Copolovici

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The effects assessment of environmental stress factors on both crop and wild plants of nutritional value are a very important research topic. Continuously worldwide consumption of drugs leads to significant environmental pollution, thus generating environmental stress. Understanding the effects of the important drugs on plant composition and ultrastructural modification is still limited, especially at environmentally relevant concentrations. The aim of the present work was to investigate the influence of three non-steroidal anti-inflammatory drugs (NSAIDs) on chlorophylls content, carotenoids content, total polyphenols content, antioxidant capacity, and ultrastructure of orache (Atriplex patula L.) and spinach (Spinacia oleracea L.). All green leafy vegetables selected for this study were grown in controlled conditions and treated with solutions of different concentrations (0.1‒1 mg L⁻¹) of diclofenac, ibuprofen, and naproxen. After eight weeks of exposure of the plants to NSAIDs, the chlorophylls and carotenoids content were analyzed by high-performance liquid chromatography coupled with photodiode array and mass spectrometer detectors, total polyphenols and antioxidant capacity by ultraviolet-visible spectroscopy. Also, the ultrastructural analyses of the vegetables were performed using transmission electron microscopy in order to assess the influence of the selected NSAIDs on cellular organisms, mainly photosynthetic organisms (chloroplasts), energy supply organisms (mitochondria) and nucleus as a cellular metabolism coordinator. In comparison with the control plants, decreases in the content of chlorophylls were observed in the case of the Atriplex patula L. plants treated with ibuprofen (11-34%) and naproxen (25-52%). Also, the chlorophylls content from Spinacia oleracea L. was affected, the lowest decrease (34%) being obtained in the case of the treatment with naproxen (1 mg L⁻¹). Diclofenac (1 mg L⁻¹) affected the total polyphenols content (a decrease of 45%) of Atriplex patula L. and ibuprofen (1 mg L⁻¹) affected the total polyphenols content (a decrease of 20%) of Spinacia oleracea L. The results obtained also indicate a moderate reduction of carotenoids and antioxidant capacity in the treated plants, in comparison with the controls. The investigations by transmission electron microscopy demonstrated that the green leafy vegetables were affected by the selected NSAIDs. Thus, this research contributes to a better understanding of the adverse effects of these drugs on studied plants. Important to mention is that the dietary intake of these drugs contaminated plants, plants with important nutritional value, may also presume a risk to human health, but currently little is known about the fate of the drugs in plants and their effect on or risk to the ecosystem.

Keywords: abiotic stress, green leafy vegetables, pigments content, ultra structure

Procedia PDF Downloads 123

Authors: Athina Thanou, Eirini Eleni Tsiropoulou, Symeon Papavassiliou

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The problem of museum visitor experience and congestion management – in various forms - has come increasingly under the spotlight over the last few years, since overcrowding can significantly decrease the quality of visitors’ experience. Evidence suggests that on busy days the amount of time a visitor spends inside a crowded house museum can fall by up to 60% compared to a quiet mid-week day. In this paper we consider the aforementioned problem, by treating museums as evolving social systems that induce constraints. However, in a cultural heritage space, as opposed to the majority of social environments, the momentum of the experience is primarily controlled by the visitor himself. Visitors typically behave selfishly regarding the maximization of their own Quality of Experience (QoE) - commonly expressed through a utility function that takes several parameters into consideration, with crowd density and waiting/visiting time being among the key ones. In such a setting, congestion occurs when either the utility of one visitor decreases due to the behavior of other persons, or when costs of undertaking an activity rise due to the presence of other persons. We initially investigate how visitors’ behavioral risk attitudes, as captured and represented by prospect theory, affect their decisions in resource sharing settings, where visitors’ decisions and experiences are strongly interdependent. Different from the majority of existing studies and literature, we highlight that visitors are not risk neutral utility maximizers, but they demonstrate risk-aware behavior according to their personal risk characteristics. In our work, exhibits are organized into two groups: a) “safe exhibits” that correspond to less congested ones, where the visitors receive guaranteed satisfaction in accordance with the visiting time invested, and b) common pool of resources (CPR) exhibits, which are the most popular exhibits with possibly increased congestion and uncertain outcome in terms of visitor satisfaction. A key difference is that the visitor satisfaction due to CPR strongly depends not only on the invested time decision of a specific visitor, but also on that of the rest of the visitors. In the latter case, the over-investment in time, or equivalently the increased congestion potentially leads to “exhibit failure”, interpreted as the visitors gain no satisfaction from their observation of this exhibit due to high congestion. We present a framework where each visitor in a distributed manner determines his time investment in safe or CPR exhibits to optimize his QoE. Based on this framework, we analyze and evaluate how visitors, acting as prospect-theoretic decision-makers, respond and react to the various pricing policies imposed by the museum curators. Based on detailed evaluation results and experiments, we present interesting observations, regarding the impact of several parameters and characteristics such as visitor heterogeneity and use of alternative pricing policies, on scalability, user satisfaction, museum capacity, resource fragility, and operation point stability. Furthermore, we study and present the effectiveness of alternative pricing mechanisms, when used as implicit tools, to deal with the congestion management problem in the museums, and potentially decrease the exhibit failure probability (fragility), while considering the visitor risk preferences.

Keywords: museum resource and visitor management, congestion management, propsect theory, cyber physical social systems

Procedia PDF Downloads 178

Authors: Rishi Pal Singh

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In Indian Scenario, Organic agriculture is growing by the conscious efforts of inspired people who are able to create the best promising relationship between the earth and men. Nowadays, the major challenge is its entry into the policy-making framework, its entry into the global market and weak sensitization among the farmers. But, during the last two decades, the contamination in environment and food which is linked with the bad agricultural potential/techniques has diverted the mind set of farmers towards the organic farming. In the view of above concept, a small-scale project has been installed to promote the 20 farmers from the Kunjura and surrounding villages for organic farming. This project is working since from the last 3 crops (starting from October, 2016) and found that it can meet both demands and complete development of rural areas. Farmers of this concept are working on the principles such that the nature never demands unreasonable quantities of water, mining and to destroy the microbes and other organisms. As per details of Organic Monitor estimates, global sales reached in billion in the present analysis. In this initiative, firstly, wheat and rice were considered for farming and observed that the production of crop has grown almost 10-15% per year from the last crop production. This is not linked only with the profit or loss but also emphasized on the concept of health, ecology, fairness and care of soil enrichment. Several techniques were used like use of biological fertilizers instead of chemicals, multiple cropping, temperature management, rain water harvesting, development of own seed, vermicompost and integration of animals. In the first year, to increase the fertility of the land, legumes (moong, cow pea and red gram) were grown in strips for the 60, 90 and 120 days. Simultaneously, the mixture of compost and vermicompost in the proportion of 2:1 was applied at the rate of 2.0 ton per acre which was enriched with 5 kg Azotobacter and 5 kg Rhizobium biofertilizer. To complete the amount of phosphorus, 250 kg rock phosphate was used. After the one month, jivamrut can be used with the irrigation water or during the rainy days. In next season, compost-vermicompost mixture @ 2.5 ton/ha was used for all type of crops. After the completion of this treatment, now the soil is ready for high value ordinary/horticultural crops. The amount of above stated biofertilizers, compost-vermicompost and rock phosphate may be increased for the high alternative fertilizers. The significance of the projects is that now the farmers believe in cultural alternative (use of disease-free their own seed, organic pest management), maintenance of biodiversity, crop rotation practices and health benefits of organic farming. This type of organic farming projects should be installed at the level of gram/block/district administration.

Keywords: organic farming, Kunjpura, compost, bio-fertilizers

Procedia PDF Downloads 192

Authors: Areej K. Al-Jwaid, Dmitiry Berllio, Andrew Cundy, Irina Savina, Jonathan L. Caplin

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Phenol is a toxic compound that is widely distributed in the environment including the atmosphere, water and soil, due to the release of effluents from the petrochemical and pharmaceutical industries, coking plants and oil refineries. Moreover, a range of daily products, using phenol as a raw material, may find their way into the environment without prior treatment. The toxicity of phenol effects both human and environment health, and various physio-chemical methods to remediate phenol contamination have been used. While these techniques are effective, their complexity and high cost had led to search for alternative strategies to reduce and eliminate high concentrations of phenolic compounds in the environment. Biological treatments are preferable because they are environmentally friendly and cheaper than physico-chemical approaches. Some microorganisms such as Pseudomonas sp., Rhodococus sp., Acinetobacter sp. and Bacillus sp. have shown a high ability to degrade phenolic compounds to provide a sole source of energy. Immobilisation process utilising various materials have been used to protect and enhance the viability of cells, and to provide structural support for the bacterial cells. The aim of this study is to develop a new approach to the bioremediation of phenol based on an immobilisation strategy that can be used in wastewater. In this study, two bacterial species known to be phenol degrading bacteria (Pseudomonas mendocina and Rhodococus koreensis) were purchased from National Collection of Industrial, Food and Marine Bacteria (NCIMB). The two species and mixture of them were immobilised to produce macro porous crosslinked cell cryogels samples by using four types of cross-linker polymer solutions in a cryogelation process. The samples were used in a batch culture to degrade phenol at an initial concentration of 50mg/L at pH 7.5±0.3 and a temperature of 30°C. The four types of polymer solution - i. glutaraldehyde (GA), ii. Polyvinyl alcohol with glutaraldehyde (PVA+GA), iii. Polyvinyl alcohol–aldehyde (PVA-al) and iv. Polyetheleneimine–aldehyde (PEI-al), were used at different concentrations, ranging from 0.5 to 1.5% to crosslink the cells. The results of SEM and rheology analysis indicated that cell-cryogel samples crosslinked with the four cross-linker polymers formed monolithic macro porous cryogels. The samples were evaluated for their ability to degrade phenol. Macro porous cell–cryogels crosslinked with GA and PVA+GA showed an ability to degrade phenol for only one week, while the other samples crosslinked with a combination of PVA-al + PEI-al at two different concentrations have shown higher stability and viability to reuse to degrade phenol at concentration (50 mg/L) for five weeks. The initial results of using crosslinked cell cryogel samples to degrade phenol indicate that is a promising tool for bioremediation strategies especially to eliminate and remove the high concentration of phenol in wastewater.

Keywords: bioremediation, crosslinked cells, immobilisation, phenol degradation

Procedia PDF Downloads 230

Authors: M. Iqbal Hossain, Azharul Islam Khan, S. M. Rafiqul Islam, Tahmeed Ahmed

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Objective: Moderate acute malnutrition (MAM) is a major cause of morbidity and mortality in under-5 children of low-income countries. Approximately 14.6% of all under-5 mortality worldwide is attributed to MAM with >3 times increased risk of death compared to well-nourished peers. Prevalence of MAM among under-5 children in Bangladesh is ~12% (~1.7 million). Providing a diet containing adequate nutrients is the mainstay of treatment of children with MAM. It is now possible to process fish into fish peptides with longer shelf-life without refrigerator, known as ‘Fish Surimi peptide’ and this could be an attractive alternative to supply fish protein in the diet of children in low-income countries like Bangladesh. We conducted this study to assess the acceptability of Fish Surimi peptide given with various foods/meals in 2-5 years old children with MAM. Design/methods: Fish Surimi peptide is broken down from white fish meat using plant-derived enzyme and the ingredient is just fish meat consisted of 20 different kinds of amino acids including nine essential amino acids. In a convenience sample of 34 children we completed the study ward of Dhaka Hospital of icddr,b in Bangladesh during November 2014 through February 2015. For each child the study was for two consecutive days: i.e. direct observation of food intake of two lunches and two suppers. In a randomly and blinded manner and cross over design an individual child received Fish Surimi peptide (5g at lunch and 5g at supper) mixed meal [e.g. 30g rice and 30g dahl (thick lentil soup) or 60g of a vegetables-lentil-rice mixed local dish known as khichuri in one day and the same meal on other day without any Fish Surimi peptide. We observed the completeness and eagerness of eating and any possible side effect (e.g. allergy, vomiting, diarrhea etc.) over these two days. Results: The mean±SD age of the enrolled children was 38.4±9.4 months, weight 11.22±1.41 kg, height 91.0±6.3 cm, and WHZ was -2.13±0.76. Their mean±SD total feeding time (minutes) for lunch was 25.4±13.6 vs. 20.6±11.1 (p=0.130) and supper was 22.3±9.7 vs. 19.7±11.2 (p=0.297), and total amount (g) of food eaten in lunch and supper was found similar 116.1±7.0 vs. 117.7±8.0 (p=3.01) in A (Fish Surimi) and B group respectively. Score in Hedonic scale by mother on test of food given to children at lunch or supper was 3.9±0.2 vs. 4.0±0.2 (p=0.317) and on overall acceptance (including the texture, smell, and appearance) of food at lunch or supper was 3.9±0.2 vs. 4.0±0.2 (p=0.317) for A and B group respectively. No adverse event was observed in any food group during the study period. Conclusions: Fish Surimi peptide may be a cost effective supplementary food, which should be tested by appropriately designed randomized community level intervention trial both in wasted children and stunted children.

Keywords: protein-energy malnutrition, moderate acute malnutrition, weight-for-height z-score, mid upper arm circumference, acceptability, fish surimi peptide, under-5 children

Procedia PDF Downloads 403

Authors: S. M. Ashikur Elahee, Md. Zahidur Rahman, Md. Shofiqur Rahman

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This study evaluated the impact of different water interventions under WASH program on access of household's to safe drinking water. Following survey method, the study was carried out in two Upazila of South-west coastal region of Bangladesh namely Koyra from Khulna and Shymnagar from Satkhira district. Being an explanatory study, a total of 200 household's selected applying random sampling technique were interviewed using a structured interview schedule. The predicted probability suggests that around 62 percent household's are out of year-round access to safe drinking water whereby, only 25 percent household's have access at SPHERE standard (913 Liters/per person/per year). Besides, majority (78 percent) of the household's have not accessed at both indicators simultaneously. The distance from household residence to the water source varies from 0 to 25 kilometer with an average distance of 2.03 kilometers. The study also reveals that the increase in monthly income around BDT 1,000 leads to additional 11 liters (coefficient 0.01 at p < 0.1) consumption of safe drinking water for a person/year. As expected, lining up time has significant negative relationship with dependent variables i.e., for higher lining up time, the probability of getting access for both SPHERE standard and year round access variables becomes lower. According to ordinary least square (OLS) regression results, water consumption decreases at 93 liters for per person/year of a household if one member is added to that household. Regarding water consumption intensity, ordered logistic regression (OLR) model shows that one-minute increase of lining up time for water collection tends to reduce water consumption intensity. On the other hand, as per OLS regression results, for one-minute increase of lining up time, the water consumption decreases by around 8 liters. Considering access to Deep Tube Well (DTW) as a reference dummy, in OLR, the household under Pond Sand Filter (PSF), Shallow Tube Well (STW), Reverse Osmosis (RO) and Rainwater Harvester System (RWHS) are respectively 37 percent, 29 percent, 61 percent and 27 percent less likely to ensure year round access of water consumption. In line of health impact, different type of water born diseases like diarrhea, cholera, and typhoid are common among the coastal community caused by microbial impurities i.e., Bacteria, Protozoa. High turbidity and TDS in pond water caused by reduction of water depth, presence of suspended particle and inorganic salt stimulate the growth of bacteria, protozoa, and algae causes affecting health hazard. Meanwhile, excessive growth of Algae in pond water caused by excessive nitrate in drinking water adversely effects on child health. In lieu of ensuring access at SPHERE standard, we need to increase the number of water interventions at reasonable distance, preferably a half kilometer away from the dwelling place, ensuring community peoples involved with its installation process where collectively owned water intervention is found more effective than privately owned. In addition, a demand-responsive approach to supply of piped water should be adopted to allow consumer demand to guide investment in domestic water supply in future.

Keywords: access, impact, safe drinking water, Sphere standard, water interventions

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Authors: Piotr Wadolowski, Grzegorz Krzesinski, Piotr Gutowski

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The aim of the presented investigation is to recognize the possible mechanical issues of mini-plate connection used to treat mandible fractures and to check the impact of different factors for the stresses and displacements within the bone-stabilizer system. The mini-plate osteosynthesis technique is a common type of internal fixation using metal plates connected to the fractured bone parts by a set of screws. The selected two types of plate application methodology used by maxillofacial surgeons were investigated in the work. Those patterns differ in location and number of plates. The bone geometry was modeled on the base of computed tomography scans of hospitalized patient done just after mini-plate application. The solid volume geometry consisting of cortical and cancellous bone was created based on gained cloud of points. Temporomandibular joint and muscle system were simulated to imitate the real masticatory system behavior. Finite elements mesh and analysis were performed by ANSYS software. To simulate realistic connection behavior nonlinear contact conditions were used between the connecting elements and bones. The influence of the initial compression of the connected bone parts or the gap between them was analyzed. Nonlinear material properties of the bone tissues and elastic-plastic model of titanium alloy were used. The three cases of loading assuming the force of magnitude of 100N acting on the left molars, the right molars and the incisors were investigated. Stress distribution within connecting plate shows that the compression of the bone parts in the connection results in high stress concentration in the plate and the screws, however the maximum stress levels do not exceed material (titanium) yield limit. There are no significant differences between negative offset (gap) and no-offset conditions. The location of the external force influences the magnitude of stresses around both the plate and bone parts. Two-plate system gives generally lower von Misses stress under the same loading than the one-plating approach. Von Mises stress distribution within the cortical bone shows reduction of high stress field for the cases without the compression (neutral initial contact). For the initial prestressing there is a visible significant stress increase around the fixing holes at the bottom mini-plate due to the assembly stress. The local stress concentration may be the reason of bone destruction in those regions. The performed calculations prove that the bone-mini-plate system is able to properly stabilize the fractured mandible bone. There is visible strong dependency between the mini-plate location and stress distribution within the stabilizer structure and the surrounding bone tissue. The results (stresses within the bone tissues and within the devices, relative displacements of the bone parts at the interface) corresponding to different models of the connection provide a basis for the mechanical optimization of the mini-plate connections. The results of the performed numerical simulations were compared to clinical observation. They provide information helpful for better understanding of the load transfer in the mandible with the stabilizer and for improving stabilization techniques.

Keywords: finite element modeling, mandible fracture, mini-plate connection, osteosynthesis

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Authors: Vishnu Emani, Andreas Escher, Ellen Roche

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Background: Orthostatic hypotension (OH) is an autonomic disorder marked by a sudden drop in blood pressure upon standing resulting from autonomic dysfunction. OH is especially prevalent in elderly populations, affecting more than 30% of Americans over the age of 70. OH is one of the most significant risk factors for accidental falls in elderly populations, making it a crucial focus for medical and device therapies. Pharmacologic therapy with midodrine and fludrocortisone may alleviate hypotension but have significant adverse side effects. Abdominal passive compression devices (binders) are more effective than lower extremity compression stockings at mitigating postural hypotension, by improving venous return to the heart. However, abdominal binders are difficult to don and uncomfortable to wear, leading to poor compliance. A disadvantage of passive compression devices is their inability to selectively compress during the crucial moment of standing. it have recently developed an active compression device that applies external pressure on the abdomen during transition from prone to supine position and conducted initial prototype testing. Methods: An active abdominal compression device was developed utilizing a simple, servo-driven strap-tightening mechanism to supply tension onto foam fabric, which applies pressure to the abdomen. Healthy volunteers (n=5) were utilized for prototype testing and were subjected to three conditions: no compression, passive compression (i.e. standard abdominal binder), and active compression (device prototype). Abdominal applied pressure during device activation was measured by strain-gauge manometer placed between the skin and binder. Systolic (SBP) and mean (MAP) arterial blood pressure was measured by standard blood pressure cuff in supine position followed by repeat measurements at 1 minute intervals for 5 minutes following upright position. A survey tool was administered to determine scores (1-10) for comfort and ease of donning abdominal binders. Results: Abdominal pressure increased from 0 to 15±3 mmHg upon device activation for both passive and active compression devices. During transition from supine to upright position, both active and passive compression devices demonstrated significantly higher MAP compared to the no-compression condition (67±4, 68±5, 62±5 respectively P<0.05), but there was no statistically significant difference in SBP or MAP when comparing active to passive compression. Active compression demonstrated significantly higher comfort scores (8.3±1) compared to passive compression (3.2±2) but lower when compared to no compression (10). Subjects universally reported that active compression device was easier to don compared to passive device. Conclusions: Active or passive abdominal compression prevents hypotension associated with postural changes. Active compression is associated with increased comfort and ease of donning compared to passive compression devices. Future trials are warranted to investigate the efficacy of our device in patients with OH.

Keywords: orthostatic hypotension, compression binder, abdominal binder, active abdominal compression

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Authors: Olia Kanevskaia

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Standardization has been in the limelight of numerous academic studies. Typically described as ‘any set of technical specifications that either provides or is intended to provide a common design for a product or process’, standards do not only set quality benchmarks for products and services, but also spur competition and innovation, resulting in advantages for manufacturers and consumers. Their contribution to globalization and technology advancement is especially crucial in the Information and Communication Technology (ICT) and telecommunications sector, which is also characterized by a weaker state-regulation and expert-based rule-making. Most of the standards developed in that area are interoperability standards, which allow technological devices to establish ‘invisible communications’ and to ensure their compatibility and proper functioning. This type of standard supports a large share of our daily activities, ranging from traffic coordination by traffic lights to the connection to Wi-Fi networks, transmission of data via Bluetooth or USB and building the network architecture for the Internet of Things (IoT). A large share of ICT standards is developed in the specialized voluntary platforms, commonly referred to as Standards Development Organizations (SDOs), which gather experts from various industry sectors, private enterprises, governmental agencies and academia. The institutional architecture of these bodies can vary from semi-public bodies, such as European Telecommunications Standards Institute (ETSI), to industry-driven consortia, such as the Internet Engineering Task Force (IETF). The past decades witnessed a significant shift of standard setting to those institutions: while operating independently from the states regulation, they offer a rather informal setting, which enables fast-paced standardization and places technical supremacy and flexibility of standards above other considerations. Although technical norms and specifications developed by such nongovernmental platforms are not binding, they appear to create significant regulatory impact. In the United States (US), private voluntary standards can be used by regulators to achieve their policy objectives; in the European Union (EU), compliance with harmonized standards developed by voluntary European Standards Organizations (ESOs) can grant a product a free-movement pass. Moreover, standards can de facto manage the functioning of the market when other regulative alternatives are not available. Hence, by establishing (potentially) mandatory norms, SDOs assume regulatory functions commonly exercised by States and shape their own legal order. The purpose of this paper is threefold: First, it attempts to shed some light on SDOs’ institutional architecture, focusing on private, industry-driven platforms and comparing their regulatory frameworks with those of formal organizations. Drawing upon the relevant scholarship, the paper then discusses the extent to which the formulation of technological standards within SDOs constitutes a private legal order, operating in the shadow of governmental regulation. Ultimately, this contribution seeks to advise whether a state-intervention in industry-driven standard setting is desirable, and whether the increasing regulatory importance of SDOs should be addressed in legislation on standardization.

Keywords: private order, standardization, standard-setting organizations, transnational law

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Authors: Vivek Garg, Brajendra S. Sengar, Gaurav Siddharth, Nisheka Anadkat, Amitesh Kumar, Shailendra Kumar, Shaibal Mukherjee

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CuInGaSe (CIGSe) is the dominant thin film solar cell technology. The band alignment of Buffer/CIGSe interface is one of the most crucial parameters for solar cell performance. In this article, the valence band offset (VBOff) and conduction band offset (CBOff) values of Cu(In0.70Ga0.30)Se/ 1 at.% Ga: Mg0.25Zn0.75O (GMZO) heterojunction, grown by dual ion beam sputtering system (DIBS), are calculated to understand the carrier transport mechanism at the heterojunction for the realization of all sputtered buffer-less solar cells. To determine the valence band offset (VBOff), ∆E_V at GMZO/CIGSe heterojunction interface, the standard method based on core-level photoemission is utilized. The value of ∆E_V can be evaluated by considering common core-level peaks. In our study, the values of (Valence band onset)VBOn, obtained by linear extrapolation method for GMZO and CIGSe films are calculated to be 2.86 and 0.76 eV. In the UPS spectra peak positions of Se 3d is observed in UPS spectra at 54.82 and 54.7 eV for CIGSe film and GMZO/CIGSe interface respectively, while the peak position of Mg 2p is observed at 50.09 and 50.12 eV for GMZO and GMZO/CIGSe interface respectively. The optical band gap of CIGSe and GMZO are obtained from absorption spectra procured from spectroscopic ellipsometry are 1.26 and 3.84 eV respectively. The calculated average values of ∆E_v and ∆E_C are estimated to be 2.37 and 0.21 eV, respectively, at room temperature. The calculated positive conduction band offset termed as a spike at the absorber junction is the required criterion for the high-efficiency solar cells for the efficient charge extraction from the junction. So we can conclude that the above study confirms GMZO thin films grown by the dual ion beam sputtering system are the suitable candidate for the CIGSe thin films based ultra-thin buffer-less solar cells. We investigated the band-offset properties at the GMZO/CIGSe heterojunction to verify the suitability of the GMZO for the realization of the buffer-less solar cells. The calculated average values of ∆E_V and ∆E_C are estimated to be 2.37 and 0.21 eV, respectively, at room temperature. The calculated positive conduction band offset termed as a spike at the absorber junction is the required criterion for the high-efficiency solar cells for the efficient charge extraction from the junction. So we can conclude that the above study confirms GMZO thin films grown by the dual ion beam sputtering system are the suitable candidate for the CIGSe thin films based ultra-thin buffer-less solar cells. Acknowledgment: We are thankful to DIBS, EDX, and XRD facility equipped at Sophisticated Instrument Centre (SIC) at IIT Indore. The authors B.S.S and A.K acknowledge CSIR and V.G acknowledge UGC, India for their fellowships. B.S.S is thankful to DST and IUSSTF for BASE Internship Award. Prof. Shaibal Mukherjee is thankful to DST and IUSSTF for BASE Fellowship and MEITY YFRF award. This work is partially supported by DAE BRNS, DST CERI, and DST-RFBR Project under India-Russia Programme of Cooperation in Science and Technology. We are thankful to Mukul Gupta for SIMS facility equipped at UGC-DAE Indore.

Keywords: CIGSe, DIBS, GMZO, solar cells, UPS

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Authors: Cathy Basterfield

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Issue: To engage in one’s own health care, health professionals need to be aware of an individual’s specific skills and abilities for best communication. One of the most discussed is health literacy. One of the assumed skills and abilities for adults is an individuals’ health literacy. Background: A review of publicly available health content appears to assume all adult readers will have a broad and full capacity to read at a high level of literacy, often at a post-school education level. Health information writers and clinicians need to recognise one critical area for why there may be little or no change in a person’s behaviour, or no-shows to appointments. Perhaps unintentionally, they are miscommunicating with the majority of the adult population. Health information contains many literacy domains. It usually includes technical medical terms or jargon. Many fact sheets and other information require scientific literacy with or without specific numerical literacy. It may include graphs, percentages, timing, distance, or weights. Each additional word or concept in these domains decreases the readers' ability to meaningfully read, understand and know what to do with the information. An attempt to begin to read the heading where long or unfamiliar words are used will reduce the readers' motivation to attempt to read. Critically people who have low literacy are overwhelmed when pages are covered with lots of words. People attending a health environment may be unwell or anxious about a diagnosis. These make it harder to read, understand and know what to do with the information. But access to health information must consider an even wider range of adults, including those with poor school attainment, migrants, and refugees. It is also homeless people, people with mental health illnesses, or people who are ageing. People with low literacy also may include people with lifelong disabilities, people with acquired disabilities, people who read English as a second (or third) language, people who are Deaf, or people who are vision impaired. Outcome: This paper will discuss Easy English, which is developed for adults. It uses the audiences’ everyday words, short sentences, short words, and no jargon. It uses concrete language and concrete, specific images to support the text. It has been developed in Australia since the mid-2000s. This paper will showcase various projects in the health domain which use Easy English to improve the understanding and functional use of written information for the large numbers of adults in our communities who do not have the health literacy to manage a range of day to day reading tasks. See examples from consent forms, fact sheets and choice options, instructions, and other functional documents, where Easy English has been developed. This paper will ask individuals to reflect on their own work practice and consider what written information must be available in Easy English. It does not matter how cutting-edge a new treatment is; when adults can not read or understand what it is about and the positive and negative outcomes, they are less likely to be engaged in their own health journey.

Keywords: health literacy, inclusion, Easy English, communication

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