Search results for: maternal adverse childhood experiences
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4662

Search results for: maternal adverse childhood experiences

3432 Nurses' Experiences of Using Bergamot Essential Oil (Aromatherapy) on Patients with Dementia Suffering from Depression: A Pilot Study

Authors: Berit Johannessen

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Introduction: Depression and dementia are the two most common psychiatric disorders of older people. The use of antidepressants does not always have the desired effect and serious side effects are common. Aroma therapists claim that the essential oil of Bergamot has an antidepressant effect. Aromatherapy is defined as holistic or complementary medicine and is rarely used in the Norwegian public health service, but in recent years, there has been an increasing interest in, and use of complementary and alternative therapies (CAM) in the Norwegian population, and aromatherapy is one of the most widely used. Focus for this study: How do nurses experience the use of Bergamot essential oil for patients suffering from dementia and depression? Method: Action research study including 12 patients and 8 nurses. The patients were strategically selected by the nurses and were given Bergamot in a fan diffuser every day for 12 weeks. The patients' mood and behavior patterns were reported daily and the nurse`s experiences were reported weekly. Individual interviews with the nurses were conducted at the end of the project. Results: The nurses reported that bergamot had positive impact on patients mood and wellbeing, and was considered as an effective method for six patients, four had uncertain effect and two had no effect. They also reported less use of medication and that the fan diffusers were easy and pleasant to administer. They found the use of natural remedies as Bergamot inspiring and wanted to learn more about aromatherapy and its use in nursing. Some were disturbed by the smell and some had to deal with critical and negative colleagues. Conclusion: Nurses experienced aromatherapy using bergamot oil in fan diffusers as a simple and useful procedure for patients suffering from dementia and depression. The effects were varying. Further research is needed.

Keywords: aromatherapy, bergamot, dementia, depression

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3431 Considerations When Using the Beach Chair Position for Surgery

Authors: Aniko Babits, Ahmad Daoud

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Introduction: The beach chair position (BCP) is a good approach to almost all types of shoulder procedures. However, moving an anaesthetized patient from the supine to sitting position may pose a risk of cerebral hypoperfusion and potential cerebral ischaemia as a result of significant reductions in blood pressure and cardiac output. Hypocapnia in ventilated patients and impaired blood flow to the vertebral artery due to hyperextension, rotation, or tilt of the head may have an impact too. Co-morbidities that may increase the risk of cerebral ischaemia in the BCP include diabetes with autonomic neuropathy, cerebrovascular disease, cardiac disease, severe hypertension, generalized vascular disease, history of fainting, and febrile conditions. Beach chair surgery requires a careful anaesthetic and surgical management to optimize patient safety and minimize the risk of adverse outcomes. Methods: We describe the necessary steps for optimal patient positioning and the aims of intraoperative management, including anaesthetic techniques to ensure patient safety in the BCP. Results: Regardless of the anaesthetic technique, adequate patient positioning is paramount in the BCP. The key steps to BCP are aimed at optimizing surgical success and minimizing the risk of severe neurovascular complications. The primary aim of anaesthetic management is to maintain cardiac output and mean arterial pressure (MAP) to protect cerebral perfusion. Blood pressure management includes treating a fall in MAP of more than 25% from baseline or a MAP less than 70 mmHg. This can be achieved by using intravenous fluids or vasopressors. A number of anaesthetic techniques could also improve cerebral oxygenation, including avoidance of intermittent positive pressure ventilation (IPPV) with general anaesthesia (GA), using regional anaesthesia, maintaining normocapnia and normothermia, and the application of compression stockings. Conclusions: In summary, BCP is a reliable and effective position to perform shoulder procedures. Simple steps to patient positioning and careful anaesthetic management could maximize patient safety and avoid unwanted adverse outcomes in patients undergoing surgery in BCP.

Keywords: beach chair position, cerebral oxygenation, cerebral perfusion, sitting position

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3430 Accessibility Centres in Higher Education Institutions: Inclusiveness and Peer Tutoring Programmes

Authors: Vassilis Argyropoulos, Magda Nikolaraizi, Maria Papazafiri

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A growing number of students with disabilities attend institutions of higher education, and according to evidenced-based data, it seems that they face many obstacles regarding their academic access and inclusion. The fact that more and more students decide to actively participate in higher education, on the one hand, empowers and strengthens inclusiveness in tertiary education, but on the other hand, it brings new challenges to their access to scientific content as well as to their interactions with other students and faculty members. For this, accessibility centres have come to the fore in many higher education institutions, in order to respond to the needs of students with disabilities. In this paper, we present a study regarding the peer tutoring program, which is a service delivered by the Accessibility Centre at the University of Thessaly in Greece. Specifically, the current paper aims to describe the experiences of tutees and tutors regarding their relationships developed throughout the peer tutoring program. Twelve tutors and eight tutees with disabilities participated in the study, whose experiences were explored through interviews and were analyzed in a qualitative way. In our study, all tutees and most of the tutors described their relationship as friendly, while a few tutors preferred a more formal relationship. Also, both tutors and tutees described some of the challenges, such as setting limits or arranging an appointment. Finally, peer tutoring programs seem very promising, but in order to be effective, there is a need for training and supporting students regarding their role as well as monitoring the progress of the peer tutoring program, ensuring its smooth operation and success for both tutors and tutees.

Keywords: disability, higher education institutions, interviews, peer tutoring, inclusiveness

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3429 The Investigation of Effect of Alpha Lipoic Acid against Damage on Neonatal Rat Lung to Maternal Tobacco Smoke Exposure

Authors: Elif Erdem, Nalan Kaya, Gonca Ozan, Durrin Ozlem Dabak, Enver Ozan

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This study was carried out to determine the histological and biochemical changes in the lungs of the rat pups exposed to tobacco smoke during pregnancy period and to investigate the protective effects of alpha lipoic acid, which is administered during pregnancy, on these changes. In our study, 24 six-week old Spraque-Dawley female rats weighing 160 ± 10 g were used (n:7). Rats were randomly divided into four equal groups: group I (control), group II (tobacco smoke), group III (tobacco smoke + alpha lipoic acid) and group IV (alpha lipoic acid). Rats in the group II, group III were exposed to tobacco smoke twice a day for one hour starting from eight weeks before mating and during pregnancy. In addition to tobacco smoke, 20 mg/kg of alpha lipoic acid was administered via oral gavage to the rats in the group III. Only alpha lipoic acid was administered to the rats in the group IV. Once after the delivery, all administrations were stopped. On the 7 and 21th days, the seven pups of all groups were decapitated. A portion of the lung was taken and stained with HE, PAS and Masson. In addition to immunohistochemical staining of surfactant protein A, vascular endothelial growth factor, caspase-3, TUNEL method was also used to determine apoptosis. Biochemical analyzes were performed with some part of the lung tissue specimens. In the histological evaluations performed under light microscopy, inflammatory cell increase, hemorrhagic areas, edema, interalveolar septal thickening, alveolar numbers decrease, degeneration of some bronchi and bronchial epithelium, epithelial cells that were fallen into the lumen and hyaline membrane formation were observed in tobacco smoke group. These findings were ameliorated in tobacco smoke + ALA group. Hyaline membrane formation was not detected in this group. The TUNEL positive cell numbers a significant increase was detected in the tobacco smoke group, whereas a significant decrease was detected in the tobacco smoke + ALA group. In terms of the immunoreactivity of both SP-A and VEGF, a significant decrease was observed in the tobacco smoke group, and a significant increase was observed in the tobacco smoke + ALA group. Regarding the immunoreactivity of caspase-3, there was a significant increase in the group of tobacco smoke and a significant decrease in the group of tobacco smoke + ALA. The malondialdehyde levels were determined to be significantly increased in the tobacco smoke group, and a significant decreased in the tobacco smoke + ALA. Glutathione and superoxide dismutase enzyme activities showed a significant decrease in the group of tobacco smoke and a significant increase in the tobacco smoke + ALA group. In conclusion, we suggest that the exposure to tobacco smoke during pregnancy leads to morphological, histopathological and functional changes on lung development by causing oxidative damage in lung tissues of neonatal rats and the maternal use of alpha lipoic acid can provide a protective effect on the neonatal lung development against this oxidative stress originating from tobacco smoke.

Keywords: alpha lipoic acid, lung, neonate, tobacco smoke, pregnancy

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3428 Experiences of Extension Officers on the Provision of Agricultural Facilities to Rural Farmers towards Improving Agricultural Practice in South Africa

Authors: Mfaniseni Wiseman Mbatha

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The extension officers are regarded as the key role players in the provision of agricultural facilities to farmers across the world. The government of South Africa has shown a commitment to provide extensive support to farmers by the means of disseminating information and other agricultural facilities. This qualitative study on the experiences of extension officers on the provision of agricultural facilities to rural farmers towards improving agricultural practice was conducted in Msinga Local Municipality. The data was collected through the use of semi-structured interviews with extension officers who were sampled using the purposive sampling method. The qualitative data was analysed through the use of content analysis. The critical part of the findings reveals that the availability of arable land for agricultural practice, availability of agricultural schemes and availability of proper functioning community gardens were indicators of the high level of agricultural practice in the Msinga area. Therefore, the extension officers from the municipality department have shown to provide the agricultural budget to support rural farmers. Whereas, the department of agriculture provides well knowledgeable staff to train farmers about the process of farming and how they can address issues of livestock and crop diseases and also adapting to issues of climate change. The rural farmers, however, find it very difficult to learn and put into practice things that were thought by extension officers during training. There is, therefore, a need for recruitment of more extension staff and the involvement of Non-Government Organizations to increase access to extension facilities to the farmers.

Keywords: agricultural facilities, agricultural practice, extension officers, rural farmers

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3427 The Preventive Effect of Metformin on Paclitaxel-Induced Peripheral Neuropathy

Authors: AliAkbar Hafezi, Jamshid Abedi, Jalal Taherian, Behnam Kadkhodaei, Mahsa Elahi

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Background. Peripheral neuropathy is a common side effect of the administration of neurotoxic chemotherapy agents. This adverse effect is a major dose-limiting factor of many commonly used chemotherapy drugs. Currently, there are no Food and Drug Administration (FDA) approved medications for the prevention or treatment of chemotherapy-induced peripheral neuropathy. Therefore, this study was performed to investigate the efficacy and safety of metformin on paclitaxel-induced peripheral neuropathy (PIPN). Methods. In this randomized clinical trial, cancer patients who were candidates for chemotherapy with paclitaxel referred to the radiation oncology departments in Iran from 2022 to 2023 were studied. Patients were randomly divided into two groups; 1- Case group (n = 30) received metformin 500 mg orally twice a day after meals during chemotherapy with paclitaxel, and 2- Control group (30 people) received chemotherapy without metformin or any additional medication. Patients were visited in terms of numbness or other neurological symptoms two weeks before chemotherapy, 1-2 days before and weekly during chemotherapy, and at the end of the study. They were assessed by nerve conduction study (NCS) before intervention and one week after the end of chemotherapy. The primary outcome was the efficacy in reducing PIPN and the secondary outcome was adverse effects. Eventually, the outcomes were compared between the two groups of patients. Results. A total of 60 female cancer patients receiving chemotherapy with paclitaxel were evaluated in two groups. The groups were matched in terms of age, body mass index, fasting blood sugar, smoking, pathologic stage, and creatinine levels. The results showed that 18 patients (60.0 %) in the case group and 23 patients (76.6 %) in the control group had PIPN clinically (P = 0.267), and NCS showed 11 patients (36.6 %) in the case group and 15 patients (50.0 %) in the control group suffered from PIPN which no significant difference was observed between the two groups (P = 0.435). Diarrhea (n = 3; 10.0 %) and nausea (n = 3; 10.0 %) were the most common side effects of metformin in the case group and no serious side effects (lactic acidosis and anemia) were found in these patients. Conclusion. This study indicated that metformin did not significantly prevent PIPN in cancer patients receiving chemotherapy, although the frequency of peripheral neuropathy in the case group was lower than in the control group. The use of metformin in the patients had acceptable safety and no serious side effects were reported.

Keywords: peripheral neuropathy, chemotherapy, paclitaxel, metformin

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3426 Cyber Bullying, Online Risks and Parental Mediation: A Comparison between Adolescent Reports and Parent Perceptions in South Africa

Authors: Masa Popovac, Philip Fine

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Information and Communication Technologies (ICTs) have altered our social environments, and young people in particular have immersed themselves in the digital age. Despite countless benefits, younger ICT users are being exposed to various online risks such as contact with strangers, viewing of risky content, sending or receiving sexually themed images or comments (i.e. ‘sexting’) as well as cyber bullying. Parents may not be fully aware of the online spaces their children inhabit and often struggle to implement effective mediation strategies. This quantitative study explored (i) three types of online risks (contact risks, content risks and conduct risks), (ii) cyber bullying victimization and perpetration, and (iii) parental mediation among a sample of 689 South African adolescents aged between 12-17 years. Survey data was also collected for 227 of their parents relating to their perceptions of their child’s online experiences. A comparison between adolescent behaviors and parental perceptions was examined on the three variables in the study. Findings reveal various online risk taking behaviors. In terms of contact risks, 56% of adolescents reported having contact with at least one online stranger, with many meeting these strangers in person. Content risks included exposure to harmful information such as websites promoting extreme diets or self-harm as well as inappropriate content: 84% of adolescents had seen violent content and 75% had seen sexual content online. Almost 60% of adolescents engaged in conduct risks such as sexting. Eight online victimization behaviors were examined in the study and 79% of adolescents had at least one of these negative experiences, with a third (34%) defining this experience as cyber bullying. A strong connection between victimization and perpetration was found, with 63% of adolescents being both a victim and perpetrator. Very little parental mediation of ICT use was reported. Inferential statistics revealed that parents consistently underestimated their child’s online risk taking behaviors as well as their cyber bullying victimization and perpetration. Parents also overestimated mediation strategies in the home. The generational gap in the knowledge and use of ICTs is a barrier to effective parental mediation and online safety, since many negative online experiences by adolescents go undetected and can continue for extended periods of time thereby exacerbating the potential psychological and emotional distress. The study highlights the importance of including parents in online safety efforts.

Keywords: cyber bullying, online risk behaviors, parental mediation, South Africa

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3425 A 20 Year Comparison of Australian Childhood Bicycle Injuries – Have We Made a Difference?

Authors: Bronwyn Griffin, Caroline Acton, Tona Gillen, Roy Kimble

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Background: Bicycle riding is a common recreational activity enjoyed by many children throughout Australia that has been associated with the usual caveat of benefits related to exercise and recreation. Given Australia was the first country in the world to introduce cyclist helmet laws in 1991, very few publications have reviewed paediatric cycling injuries (fatal or non-fatal) since. Objectives: To identify trends in children (0-16 years) who required admission for greater than 24 hours following a bicycle-related injury (fatal and non-fatal) in Queensland. Further, to discuss changes that have occurred in paediatric cycling injury trends in Queensland since a prominent local study/publication in 1995. This paper aims to establish evidence to inform interventions promoting safer riding to parents, children and communities. Methods: Data on paediatric (0-16 years) cycling injuries in Queensland resulting in hospital admission more than 24 hours across three tertiary paediatric hospitals in Brisbane between November 2008-June 2015 was compiled by the Paediatric Trauma Data Registry for non-fatal injuries. The Child Death Review Team at the Queensland Families and Childhood Commission provided data on fatalities in children <17years from (June 2004 –June 2015). Comparing trends to a local study published in 1995 Results: Between 2008-2015 there were 197 patients admitted for greater than 24 hours following a cycling injury. The median age was 11 years, with males more frequently involved (n=139, 87%) compared to females. Mean length of stay was three days, with 47 (28%) children admitted to PICU, location of injury was most often the street (n=63, 37%). Between 2004 –2015 there were 15 fatalities (Incidence rate 0.25/100,000); all were male, 14/15 occurred on the street, with eight stated to have not been wearing a helmet, 11/15 children came from the least advantaged socio-economic group (SEIFA) compared to a local publication in 1995, finding of 94 fatalities between (1981-1992). Conclusions: There has been a notable decrease in incidence of fatalities between the two time periods with incidence rates dropping from 1.75-0.25/100,000. More statistics need to be run to ascertain if this is a true reduction or perhaps a decrease in children riding bicycles. Injuries that occur on the street that come in contact with a car remain of serious concern. The purpose of this paper is not to discourage bicycle riding among child and adolescent populations, rather, inform parents and the wider community about the risks associated with cycling in order to reduce injuries associated with this sport, whilst promoting safe cycling.

Keywords: paediatric, cycling, trauma, prevention, emergency

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3424 Helping Others and Mental Health: A Qualitative Study Exploring Perspectives of Youth Engaging in Prosocial Activities

Authors: Saima Hirani, Emmanuela Ojukwu, Nilanga Aki Bandara

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Background: Mental health challenges that begin during the youth age period may continue across the entire life course. One way to support youth mental health is to encourage youth engagement in prosocial activities. This study aimed to explore youth’s perceptions about helping others and mental well-being, barriers, and enablers for youth to initiate and continue prosocial activities, and strategies for developing the attribute of helping others in youth. Methods: We conducted a qualitative study using semi-structured, virtual interviews with 18 young individuals (aged 16-24 years) living in Vancouver, British Columbia, Canada. Results: Youth perceived helping others as a source of feeling peace and calm, finding meaning in life, experiencing social connection and promoting self-care, and relieving stress. Participants reported opportunities to learn new skills, the role of religion, social connections, previous positive experiences, and role modeling as enablers for their prosocial behaviour. Heavy time commitment, negative behaviour from others, self-doubt, and late exposure to such activities were considered barriers by youth when participating in prosocial activities. Youth also brought forward key recommendations for engaging youth in helping others. Conclusions: The findings of this study support the notion that youth have positive experiences when engaging in helping others and that involving young people in prosocial activities could be used as a protective intervention for promoting youth mental health and overall well-being.

Keywords: helping others, prosocial behaviour, youth, mental well-being

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3423 Gender Cultural Scripts and Career Choices

Authors: Caroline Hoorn

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Post-matriculants in disadvantaged communities such as Douglas encounter a number of career challenges. The transition to the democratic dispensation in 1994, coupled with the rapid changes in the information domain that are characteristic of post-industrial life, complicate the career development trajectories of disadvantaged youth. The career development stories and experiences of disadvantaged youth in provinces such as the Northern Cape have not been told, leading to their marginalisation. It is against this background that the study explored the gendered dimensions of career development narratives, experiences, and choices of post-matriculants in the Douglas community in the Northern Cape. Using a qualitative, narrative approach, the researcher elicited career development stories from 23 participants in Douglas using semi-structured interviews. Two main themes were highlighted through the narratives; (1) willingness to challenge the traditional male dominated career script (2) breaking gender barriers. The study showed that gender did not have any influence on the career choices of the post-matriculants. The perceptions around career choices and gender were being challenged partly by the urge to affirm equality and the constant reminder of the poverty-stricken conditions prevalent in the households. A preferred gender is not required to be attached to the fulfilment of outcomes in a knowledge-based economy. Thus, it is not an issue of gender or masculinity but knowledge and skills. Furthermore, the study revealed that the career choices being considered are still the traditionally stereotypical careers like nursing, teaching, and social work, which demonstrates a lack of information to a broader pool of career options to select from.

Keywords: career development, gender, narratives, post-matriculants

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3422 Bullying with Neurodiverse Students and Education Policy Reform

Authors: Fharia Tilat Loba

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Studies show that there is a certain group of students who are more vulnerable to bullying due to their physical appearance, disability, sexual preference, race, and lack of social and behavioral skills. Students with autism spectrum disorders (ASD) are one of the most vulnerable groups among these at-risk groups. Researchers suggest that focusing on vulnerable groups of students who can be the target of bullying helps to understand the causes and patterns of aggression, which ultimately helps in structuring intervention programs to reduce bullying. Since Australia ratified the United Nations Convention on the Rights of Persons with Disabilities in 2006, it has been committed to providing an inclusive, safe, and effective learning environment for all children. In addition, the 2005 Disability Standards for Education seeks to ensure that students with disabilities can access and participate in education on the same basis as other students, covering all aspects of education, including harassment and victimization. However, bullying hinders students’ ability to fully participate in schooling. The proposed study aims to synthesize the notions of traditional bullying and cyberbullying and attempts to understand the experiences of students with ASD who are experiencing bullying in their schools. The proposed study will primarily focus on identifying the gaps between policy and practice related to bullying, and it will also attempt to understand the experiences of parents of students with ASD and professionals who have experience dealing with bullying at the school level in Australia. This study is expected to contribute to the theoretical knowledge of the bullying phenomenon and provide a reference for advocacy at the school, organization, and government levels.

Keywords: education policy, bullying, Australia, neurodiversity

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3421 Women's Pathways to Prison in Thailand

Authors: Samantha Jeffries, Chontit Chuenurah

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Thailand incarcerates the largest number of women and has the highest female incarceration rate in South East Asia. Since the 1990s, there has been a substantial increase in the number, rate and proportion of women imprisoned. Thailand places a high priority on the gender specific contexts out of which offending arises and the different needs of women in the criminal justice system. This is manifested in work undertaken to guide the development of the United Nations Rules for the Treatment of Women Prisoners and Non-Custodial Measures for Women Offenders (the Bangkok Rules); adopted by the United Nations General Assembly in 2010. The Bangkok Rules make a strong statement about Thailand’s recognition of and commitment to the fair and equitable treatment of women throughout their contact with the criminal justice system including at sentencing and in prison. This makes the comparatively high use of imprisonment for women in Thailand particularly concerning and raises questions about the relationship between gender, crime and criminal justice. While there is an extensive body of research in Western jurisdictions exploring women’s pathways to prison, there is a relative dearth of methodologically robust research examining the possible gendered circumstances leading to imprisonment in Thailand. In this presentation, we will report preliminary findings from a qualitative study of women’s pathways to prison in Thailand. Our research aims were to ascertain: 1) the type, frequency, and context of criminal behavior that led to women’s incarceration, 2) women’s experiences of the criminal justice system, 3) the broader life experiences and circumstances that led women to prison in Thailand. In-depth life history interviews (n=77) were utilized to gain a comprehensive understanding of women’s journeys into prison. The interview schedule was open-ended consisting of prisoner responses to broad discussion topics. This approach provided women with the opportunity to describe significant experiences in their lives, to bring together distinct chronologies of events, and to analyze links between their varied life experiences, offending, and incarceration. Analyses showed that women’s journey’s to prison take one of eight pathways which tentatively labelled as follows, the: 1) harmed and harming pathway, 2) domestic/family violence victimization pathway, 3) drug connected pathway, 4) street woman pathway, 5) economically motivated pathway, 6) jealousy anger and/or revenge pathway, 7) naivety pathway, 8) unjust and/or corrupted criminal justice pathway. Each will be fully discussed during the presentation. This research is significant because it is the first in-depth methodologically robust exploration of women’s journeys to prison in Thailand and one of a few studies to explore gendered pathways outside of western contexts. Understanding women’s pathways into Thailand’s prisons is crucial to the development of effective planning, policy and program responses not only while women are in prison but also post-release. To best meet women’s needs in prison and effectively support their reintegration, we must have a comprehensive understanding of who these women are, what offenses they commit, the reasons that trigger their confrontations with the criminal justice system and the impact of the criminal justice system on them.

Keywords: pathways, prison, women, Thailand

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3420 Transdisciplinary Pedagogy: An Arts-Integrated Approach to Promote Authentic Science, Technology, Engineering, Arts, and Mathematics Education in Initial Teacher Education

Authors: Anne Marie Morrin

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This paper will focus on the design, delivery and assessment of a transdisciplinary STEAM (Science, Technology, Engineering, Arts, and Mathematics) education initiative in a college of education in Ireland. The project explores a transdisciplinary approach to supporting STEAM education where the concepts, methodologies and assessments employed derive from visual art sessions within initial teacher education. The research will demonstrate that the STEAM Education approach is effective when visual art concepts and methods are placed at the core of the teaching and learning experience. Within this study, emphasis is placed on authentic collaboration and transdisciplinary pedagogical approaches with the STEAM subjects. The partners included a combination of teaching expertise in STEM and Visual Arts education, artists, in-service and pre-service teachers and children. The inclusion of all stakeholders mentioned moves towards a more authentic approach where transdisciplinary practice is at the core of the teaching and learning. Qualitative data was collected using a combination of questionnaires (focused and open-ended questions) and focus groups. In addition, the data was collected through video diaries where students reflected on their visual journals and transdisciplinary practice, which gave rich insight into participants' experiences and opinions on their learning. It was found that an effective program of STEAM education integration was informed by co-teaching (continuous professional development), which involved a commitment to adaptable and flexible approaches to teaching, learning, and assessment, as well as the importance of continuous reflection-in-action by all participants. The delivery of a transdisciplinary model of STEAM education was devised to reconceptualizatise how individual subject areas can develop essential skills and tackle critical issues (such as self-care and climate change) through data visualisation and technology. The success of the project can be attributed to the collaboration, which was inclusive, flexible and a willingness between various stakeholders to be involved in the design and implementation of the project from conception to completion. The case study approach taken is particularistic (focusing on the STEAM-ED project), descriptive (providing in-depth descriptions from varied and multiple perspectives), and heuristic (interpreting the participants’ experiences and what meaning they attributed to their experiences).

Keywords: collaboration, transdisciplinary, STEAM, visual arts education

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3419 Preparation of POMA Nanofibers by Electrospinning and Its Applications in Tissue Engineering

Authors: Lu-Chen Yeh‚ Jui-Ming Yeh

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In this manuscript, we produced neat electrospun poly(o-methoxyaniline) (POMA) fibers and utilized it for applying the growth of neural stem cells. The transparency and morphology of as-prepared POMA fibers were characterized by UV-visible spectroscopy and scanning electron microscopy, respectively. It was found to have no adverse effects on the long-term proliferation of the neural stem cells (NSCs), retained the ability to self-renew, and exhibit multi-potentiality. Results of immunofluorescence staining studies confirmed that POMA electrospun fibers could provide a great environment for NSCs and enhance its differentiation.

Keywords: electrospun, polyaniline, neural stem cell, differentiation

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3418 Canadian French as an Additional Language Teacher Candidates' Proficiency and Confidence Pre- and Post-Francophone Home-Stay: Practicum Experience as Revealed through Questionnaire and Interviews

Authors: Callie Mady

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This study investigated the Canadian French as an additional language teacher candidates’ confidence and language maintenance strategies by means of questionnaires and interviews pre- and post- a Francophone home-stay practicum experience. Teacher French language proficiency is one of the components of teacher knowledge that can influence students’ French as an additional language acquisition. Although advantageous, seeking opportunities to use French in a French milieu comes with challenges. Teachers, for example, have been found to be hesitant to speak French with native speakers for fear of judgment. Another identified challenge to spending time in a French milieu is finances; while teachers have recognized the value of such an experience, cost is prohibitive. In recognition of the potential barriers and the need to maintain/improve the French proficiency of 'French as an additional language' teachers, this study provided a two-week home stay in a Francophone environment for teacher candidates of French as an additional language with financial subsidies for their participation. Through the post-experience interviews, the French as an additional language teacher candidates revealed an improvement in French proficiency. Similarly, the teacher candidates cited an increase in confidence in the interviews and through the questionnaire. They linked this increase in proficiency and confidence to their experiences with their host families and other Francophone members of the community. This study highlights the provision of immersion experiences as means to support teachers’ language confidence and proficiency.

Keywords: French as an additional language education, teacher language confidence, teacher language maintenance, teacher language proficiency

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3417 Enhancement of Cross-Linguistic Effect with the Increase in the Multilingual Proficiency during Early Childhood: A Case Study of English Language Acquisition by a Pre-School Child

Authors: Anupama Purohit

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The paper is a study on the inevitable cross-linguistic effect found in the early multilingual learners. The cross-linguistic behaviour like code-mixing, code-switching, foreign accent, literal translation, redundancy and syntactic manipulation effected due to other languages on the English language output of a non-native pre-school child are discussed here. A case study method is adopted in this paper to support the claim of the title. A simultaneously tetra lingual pre-school child’s (within 1;3 to 4;0) language behaviour is analysed here. The sample output data of the child is gathered from the diary entries maintained by her family, regular observations and video recordings done since her birth. She is getting the input of her mother tongue, Sambalpuri, from her grandparents only; Hindi, the local language from her play-school and the neighbourhood; English only from her mother and occasional visit of other family friends; Odia only during the reading of the Odia story book. The child is exposed to code-mixing of all the languages throughout her childhood. But code-mixing, literal translation, redundancy and duplication were absent in her initial stage of multilingual acquisition. As the child was more proficient in English in comparison to her other first languages and had never heard code-mixing in English language; it was expected from her input pattern of English (one parent, English language) that she would maintain purity in her use of English while talking to the English language interlocutor. But with gradual increase in the language proficiency in each of the languages of the child, her handling of the multiple codes becomes deft cross-linguistically. It can be deduced from the case study that after attaining certain milestone proficiency in each language, the child’s linguistic faculty can operate at a metalinguistic level. The functional use of each morpheme, their arrangement in words and in the sentences, the supra segmental features, lexical-semantic mapping, culture specific use of a language and the pragmatic skills converge to give a typical childlike multilingual output in an intelligible manner to the multilingual people (with the same set of languages in combination). The result is appealing because for expressing the same ideas which the child used to speak (may be with grammatically wrong expressions) in one language, gradually, she starts showing cross-linguistic effect in her expressions. So the paper pleads for the separatist view from the very beginning of the holophrastic phase (as the child expresses in addressee-specific language); but development of a metalinguistic ability that helps the child in communicating in a sophisticated way according to the linguistic status of the addressee is unique to the multilingual child. This metalinguistic ability is independent of the mode if input of a multilingual child.

Keywords: code-mixing, cross-linguistic effect, early multilingualism, literal translation

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3416 Automated Recognition of Still’s Murmur in Children

Authors: Sukryool Kang, James McConnaughey, Robin Doroshow, Raj Shekhar

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Still’s murmur, a vibratory heart murmur, is the most common normal innocent murmur of childhood. Many children with this murmur are unnecessarily referred for cardiology consultation and testing, which exacts a high cost financially and emotionally on the patients and their parents. Pediatricians to date are not successful at distinguishing Still’s murmur from murmurs of true heart disease. In this paper, we present a new algorithmic approach to distinguish Still’s murmur from pathological murmurs in children. We propose two distinct features, spectral width and signal power, which describe the sharpness of the spectrum and the signal intensity of the murmur, respectively. Seventy pediatric heart sound recordings of 41 Still’s and 29 pathological murmurs were used to develop and evaluate our algorithm that achieved a true positive rate of 97% and false positive rate of 0%. This approach would meet clinical standards in recognizing Still’s murmur.

Keywords: AR modeling, auscultation, heart murmurs, Still's murmur

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3415 Prediction of Cardiovascular Markers Associated With Aromatase Inhibitors Side Effects Among Breast Cancer Women in Africa

Authors: Jean Paul M. Milambo

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Purpose: Aromatase inhibitors (AIs) are indicated in the treatment of hormone-receptive breast cancer in postmenopausal women in various settings. Studies have shown cardiovascular events in some developed countries. To date the data is sparce for evidence-based recommendations in African clinical settings due to lack of cancer registries, capacity building and surveillance systems. Therefore, this study was conducted to assess the feasibility of HyBeacon® probe genotyping adjunctive to standard care for timely prediction and diagnosis of Aromatase inhibitors (AIs) associated adverse events in breast cancer survivors in Africa. Methods: Cross sectional study was conducted to assess the knowledge of POCT among six African countries using online survey and telephonically contacted. Incremental cost effectiveness ratio (ICER) was calculated, using diagnostic accuracy study. This was based on mathematical modeling. Results: One hundred twenty-six participants were considered for analysis (mean age = 61 years; SD = 7.11 years; 95%CI: 60-62 years). Comparison of genotyping from HyBeacon® probe technology to Sanger sequencing showed that sensitivity was reported at 99% (95% CI: 94.55% to 99.97%), specificity at 89.44% (95% CI: 87.25 to 91.38%), PPV at 51% (95%: 43.77 to 58.26%), and NPV at 99.88% (95% CI: 99.31 to 100.00%). Based on the mathematical model, the assumptions revealed that ICER was R7 044.55. Conclusion: POCT using HyBeacon® probe genotyping for AI-associated adverse events maybe cost effective in many African clinical settings. Integration of preventive measures for early detection and prevention guided by different subtype of breast cancer diagnosis with specific clinical, biomedical and genetic screenings may improve cancer survivorship. Feasibility of POCT was demonstrated but the implementation could be achieved by improving the integration of POCT within primary health cares, referral cancer hospitals with capacity building activities at different level of health systems. This finding is pertinent for a future envisioned implementation and global scale-up of POCT-based initiative as part of risk communication strategies with clear management pathways.

Keywords: breast cancer, diagnosis, point of care, South Africa, aromatase inhibitors

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3414 Older Adult Grandparents' Voices as a Principle Care Giver in a Skipped-Generation Family

Authors: Kerdsiri Hongthai, Darunee Jongudomkarn, Rutja Phuphaibul

Abstract:

In Thailand, many adults in rural areas migrate to seek employ¬ment resulting in skipped-generation family where grandparents care for grandchildren with no other adults present. This is a preliminary study using qualitative case study methods, aimed to explore the situations of older adult grandparents' experiences in skipped-generation family in North-East of Thailand. Data were collected by in-depth inter¬views with 6 grandparents living in skipped-generation families; 5 females and 1 males grandparents, aged 62-75, some of them have diabetes mellitus, hypertension, during November to December, 2017. The finding themes are: ‘Caught up in the middle’: the older adults were pleased to have grandchildren but, at the same time, acknowledge the burden that this placed on them, especially when the migrant children failed to send enough money back to support the family. ‘Getting bad health’: they reported to be fatigued and stressed due to burden of caring for their grandchildren without support. This situation can aggravate problems of poor health status and be worsening economic status of the grandparents. In some cases of deprivation, the grandparents feel that having to be the sole care providers of their grandchildren can negative adversely affect their mental status. It is important to find out in other sectors similar to Thailand and lead to more in-depth research to answer the research questions about policy and social support in skipped-generation family in the future.

Keywords: older adult grandparents, experiences, principle care giver, skipped-generation family

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3413 Enabling Cloud Adoption Based Secured Mobile Banking through Backend as a Service

Authors: P. S. Jagadeesh Kumar, S. Meenakshi Sundaram

Abstract:

With the increase of prevailing non-traditional rivalry, mobile banking experiences an ever changing commercial backdrop. Substantial customer demands have established to be more intricate as customers request more expediency and superintend over their banking services. To enterprise advance and modernization in mobile banking applications, it is gradually obligatory to deeply leapfrog the scuffle using business model transformation. The dramaturgical vicissitudes taking place in mobile banking entail advanced traditions to exploit security. By reforming and transforming older back office into integrated mobile banking applications, banks can engender a supple and nimble banking environment that can rapidly respond to new business requirements over cloud computing. Cloud computing is transfiguring ecosystems in numerous industries, and mobile banking is no exemption providing services innovation, greater flexibility to respond to improved security and enhanced business intelligence with less cost. Cloud technology offer secure deployment possibilities that can provision banks in developing new customer experiences, empower operative relationship and advance speed to efficient banking transaction. Cloud adoption is escalating quickly since it can be made secured for commercial mobile banking transaction through backend as a service in scrutinizing the security strategies of the cloud service provider along with the antiquity of transaction details and their security related practices.

Keywords: cloud adoption, backend as a service, business intelligence, secured mobile banking

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3412 Immunoglobulins and Importance in Ruminants

Authors: M. Akoz, O. B. Citil, I. Aydin

Abstract:

Colostrum secreted by the mammary glands after birth in the early days, a high proportion of fat, protein and ash containing a secretion containing low amounts of casein and lactose. Especially immunoglobulins contain high proportions. Maternal immunoglobulins own immune system to protect the newborn against neonatal disease until development are very important matter. However, colostrum is transferred to the offspring due to placental barrier in ruminants. Immunoglobulins are absorbed through the intestinal epithelium but absorption can vary under the influence of some factors. These factors are among the priority ones taking colostrum first time, amount, concentration, the metabolic status of the newborn. intestinal absorption of immunoglobulins occurs over the first 24 h high. Absorption from the gut after nine hours, 50% after 24 hours was only 11%. On the other hand pup's digestive system degrade the enzymes after 24 hours immunoglobulins. Bovine colostrum in the composition while basic immune IgG, IgA and IgM are also available. Total IgG in colostrum of ruminants, while in other species is a greater amount in blood serum.

Keywords: immunoglobulin, ruminants, colostrum, immune system

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3411 Enabling Affirmative Futures: Making Use of Virtual Spaces and New Social Technologies in Co-Production Research with Marginalised Young People

Authors: Kirsty Liddiard

Abstract:

In this paper, we detail the politics and practicalities of co-produced disability research with disabled young people with life-limiting and life-threatening impairments in our ESRC funded project, Life, Death, Disability and the Human: Living Life to the Fullest. We centre our Co-Researcher Collective of disabled young people who, through virtual research methods and social technologies, are co-leading this innovative project exploring the lives, hopes, desires and ambitions of young disabled people living short(er) lives. Co-production is an established approach; however, our co-researchers have led us to develop inclusive and transformative research practices that engage with online social research methods in innovative ways. Through this discussion, we demarcate the Academy and ‘research process’ as potentially deeply ableist spaces that propogate the normative researcher as non-disabled; someone integrated into the Academy and insecure employment; and who enacts normative modes of leadership. We use our experiences of co-production in Living Life to the Fullest, then, to show that research – as a discipline, a set of politics, and scholarly practice – must be transformed in order to enable new inclusive research futures that support meaningful co-production with marginalised young people. In conclusion, as we detail our experiences, we aim to encourage disability studies researchers and others to adopt virtual environments and social technologies when researching with and for the lives of disabled people.

Keywords: co-production, illness, youth, technology

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3410 Implementing Mindfulness into Wellness Plans: Assisting Individuals with Substance Abuse and Addiction

Authors: Michele M. Mahr

Abstract:

The purpose of this study is to educate, inform, and facilitate scholarly conversation and discussion regarding the implementation of mindfulness techniques when working with individuals with substance use disorder (SUD) or addictive behaviors in mental health. Mindfulness can be recognized as the present moment, non-judgmental awareness, initiated by concentrated attention that is non-reactive and as openheartedly as possible. Individuals with SUD or addiction typically are challenged with triggers, environmental situations, cravings, or social pressures which may deter them from remaining abstinent from their drug of choice or addictive behavior. Also, mindfulness is recognized as one of the cognitive and behavioral treatment approaches and is both a physical and mental practice that encompasses individuals to become aware of internal situations and experiences with undivided attention. That said, mindfulness may be an effective strategy for individuals to employ during these experiences. This study will reveal how mental health practitioners and addiction counselors may find mindfulness to be an essential component of increasing wellness when working with individuals seeking mental health treatment. To this end, mindfulness is simply the ability individuals have to know what is actually happening as it is occurring and what they are experiencing at the moment. In the context of substance abuse and addiction, individuals may employ breathing techniques, meditation, and cognitive restructuring of the mind to become aware of present moment experiences. Furthermore, the notion of mindfulness has been directly connected to the development of neuropathways. The creation of the neural pathways then leads to creating thoughts which leads to developing new coping strategies and adaptive behaviors. Mindfulness strategies can assist individuals in connecting the mind with the body, allowing the individual to remain centered and focused. All of these mentioned above are vital components to recovery during substance abuse and addiction treatment. There are a variety of therapeutic modalities applying the key components of mindfulness, such as Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy for depression (MBCT). This study will provide an overview of both MBSR and MBCT in relation to treating individuals with substance abuse and addiction. The author will also provide strategies for readers to employ when working with clients. Lastly, the author will create and foster a safe space for discussion and engaging conversation among participants to ask questions, share perspectives, and be educated on the numerous benefits of mindfulness within wellness.

Keywords: mindfulness, wellness, substance abuse, mental health

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3409 A Qualitative Study of a Workplace International Employee Health Program

Authors: Jennifer Bradley

Abstract:

With opportunities to live and work abroad on the rise, effective preparation and support for international employees needs to be addressed within the work-site. International employees must build new habits, routines and social networks in an unfamiliar culture. Culture shock typically occurs within the first year and can affect both physical and psychological health. Employers have the opportunity to support staff through the adaptation process and foster healthy habits and routines. Cross-cultural training that includes a combination of instructional teaching, cultural experiences, and practice, is shown to increase the international employee adaptation process. However, little evidence demonstrates that organizations provide all of these aspects for international employees. The occupational therapy practitioner (OTP) offers a unique perspective focusing on the employee transactional relationship and engagement of meaningful occupations to enhance and enable participation in roles, habits and routines within new cultural contexts. This paper examines one such program developed and implemented by an OTP at the New England Center for Children, in Abu Dhabi, United Arab Emirates. The effectiveness of the program was assessed via participant feedback and concluded that an international employee support program that focuses on a variety of meaningful experiences and knowledge can empower employees to navigate healthy practices, develop habits and routines, and foster positive inter-cultural relationships in the organization and community.

Keywords: occupational therapy practitioner, cross cultural training, international employee health, international employee support

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3408 Intercultural Trainings for Future Global Managers: Evaluating the Effect on the Global Mind-Set

Authors: Nina Dziatzko, Christopher Stehr, Franziska Struve

Abstract:

Intercultural competence as an explicit required skill nearly never appears in job advertisements in international or even global contexts. But especially those who have to deal with different nationalities and cultures in their everyday business need to have several intercultural competencies and further a global mind-set. This way the question arises how potential future global managers can be trained to learn these competencies. In this regard, it might be helpful to see if different types of intercultural trainings have different effects on those skills. This paper outlines lessons learned based on the evaluation of two different intercultural trainings for management students. The main differences between the observed intercultural trainings are the amount of theoretical input in relation to hands-on experiences, the number of trainers as well as the used methods to teach implicit cultural rules. Both groups contain management students with the willingness and perspective to work abroad or to work in international context. The research is carried out with a pre-training-survey and a post-training-survey which consists of questions referring the international context of the students and a self-estimation of 19 identified intercultural and global mind-set skills, such as: cosmopolitanism, empathy, differentiation and adaptability. Whereas there is no clear result which training gets overall a significant higher increase of skills, there is a clear difference between the focus of competencies trained by each of the intercultural trainings. This way this research provides a guideline for both academicals institutions as well as companies for the decision between different types of intercultural trainings, if the to be trained required skills are defined. Therefore the efficiency and the accuracy of fit of the education of future global managers get optimized.

Keywords: global mind-set, intercultural competencies, intercultural training, learning experiences

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3407 Chronic Renal Failure Associated with Heavy Metal Contamination of Drinking Water in Hail, Kingdom of Saudi Arabia

Authors: Elsayed A. M. Shokr, A. Alhazemi, T. Naser, Talal A. Zuhair, Adel A. Zuhair, Ahmed N. Alshamary, Thamer A. Alanazi, Hosam A. Alanazi

Abstract:

The main threats to human health from heavy metals are associated with exposure to Pb, Cd, Cu, Mo, Zn, Ni, Mn Co and Cr. is mainly via intake of drinking water being the most important source in most populations. These metals have been extensively studied and their effects on human health regularly reviewed by international bodies such as the WHO. Heavy metals have been used by humans for thousands of years. Although several adverse health effects of heavy metals have been known for a long time, exposure to heavy metals continues, and is even increasing in some parts of the world, in particular in less developed countries, though emissions have declined in most developed countries over the last 100 years. A strong relationship between contaminated drinking water with heavy metals from some of the stations of water shopping in Hail, KSA and chronic diseases such as renal failure, liver cirrhosis, and chronic anemia has been identified in this study. These diseases are apparently related to contaminant drinking water with heavy metals such as Pb, Cd, Cu, Mo, Zn, Ni, Mn Co and Cr. Renal failure is related to contaminate drinking water with lead and cadmium, liver cirrhosis to copper and molybdenum, and chronic anemia to copper and cadmium. Recent data indicate that adverse health effects of cadmium exposure may occur at lower exposure levels than previously anticipated, primarily in the form of kidney damage but possibly also bone effects and fractures. The general population is primarily exposed to mercury via drinking water being a major source of methyl mercury exposure, and dental amalgam. During the last century lead, cadmium, zinc, iron and arsenic is mainly via intake of drinking water being the most important source in most populations. Long-term exposure to lead, cadmium, zinc, iron and arsenic in drinking-water is mainly related to primarily in the form of kidney damage. Studies of these diseases suggest that abnormal incidence in specific areas is related to toxic materials in the groundwater and thereby led to the contamination of drinking water in these areas.

Keywords: heavy metals, liver functions, kidney functions and chronic renal failure, hail, renal, water

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3406 An Orphan Software Engineering Course: Supportive Ways toward a True Software Engineer

Authors: Haya Sammana

Abstract:

A well-defined curricula must be adopted to meet the increasing complexity and diversity in the software applications. In reality, some IT majors such as computer science and computer engineering receive the software engineering education in a single course which is considered as a big challenged for the instructors and universities. Also, it requires students to gain the most of practical experiences that simulate the real work in software companies. Furthermore, we have noticed that there is no consensus on how, when and what to teach in that introductory course to gain the practical experiences that are required by the software companies. Because all of software engineering disciplines will not fit in just one course, so the course needs reasonable choices in selecting its topics. This arises an important question which is an essential one to ask: Is this course has the ability to formulate a true software engineer that meets the needs of industry? This question arises a big challenge in selecting the appropriate topics. So answering this question is very important for the next undergraduate students. During teaching this course in the curricula, the feedbacks from an undergraduate students and the keynotes of the annual meeting for an advisory committee from industrial side provide a probable answer for the proposed question: it is impossible to build a true software engineer who possesses all the essential elements of software engineering education such teamwork, communications skills, project management skills and contemporary industrial practice from one course and it is impossible to have a one course covering all software engineering topics. Besides the used teaching approach, the author proposes an implemented three supportive ways aiming for mitigating the expected risks and increasing the opportunity to build a true software engineer.

Keywords: software engineering course, software engineering education, software experience, supportive approach

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3405 Experiential Learning: Roles and Attributes of an Optometry Educator Recommended by a Millennial Generation

Authors: E. Kempen, M. J. Labuschagne, M. P. Jama

Abstract:

There is evidence that experiential learning is truly influential and favored by the millennial generation. However, little is known about the role and attributes an educator has to adopt during the experiential learning cycle, especially when applied in optometry education. This study aimed to identify the roles and attributes of an optometry educator during the different modes of the experiential learning cycle. Methods: A qualitative case study design was used. Data was collected using an open-ended questionnaire survey, following the application of nine different teaching-learning methods based on the experimental learning cycle. The total sample population of 68 undergraduate students from the Department of Optometry at the University of the Free State, South Africa were invited to participate. Focus group interviews (n=15) added additional data that contributed to the interpretation and confirmation of the data obtained from the questionnaire surveys. Results: The perceptions and experiences of the students identified a variety of roles and attributes as well as recommendations on the effective adoption of these roles and attributes. These roles and attributes included being knowledgeable, creating an interest, providing guidance, being approachable, building confidence, implementing ground rules, leading by example, and acting as a mediator. Conclusion: The findings suggest that the actions of an educator have the most substantial impact on students’ perception of a learning experience. Not only are the recommendations based on the views of a millennial generation, but the implementation of the personalized recommendations may also transform a learning environment. This may lead an optometry student to a deeper understanding of knowledge.

Keywords: experiences and perceptions, experiential learning, millennial generation, recommendation for optometry education

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3404 Presentation of Transgender identities

Authors: Tony Chapman-Wilson

Abstract:

Applied theatre is not an ultimate vehicle to create social change; but is more an opportunity of hope that the production material might affect this. Theatre-makers are able to deconstruct socially and politically challenging themes to encourage their audience to witness lived experiences as they consider themes of concern and injustice. This allows writers to (re) present the lived experiences of trans people, and for social injustice, continued transphobia, and lack of equity to be presented to an audience for debate. There needs to be a stronger position and presence of trans voices and active participation presented of these rather than just that of the cisgender-lens and standpoint. This research examines the relationship between human rights and theatre and considers global examples of this practice, as well as exploring the negatives formed from this relationship, and how this may be developed in the future. This focusses on the ability of theatre to denounce the violations of human rights and considers the power of theatre to support the importance of the awareness of violations to human rights for the raised awareness and potential for action of the audience – who may themselves be part of the oppressed, or indeed an oppressor. The fundamental assertion here is not one of evidenced social change, but of awareness raising of the audience and the potential for social activism and action. The practice of applied theatre is one that is experienced by the audience and the project participants alike, with the intention that theatre may consider how people interact with one another. This paper examines the opportunity of verbatim theatre techniques to allow for a cis-led trans-collaborative research project to (re) present intergenerational trans identities.

Keywords: applied theatre, verbatim, transgender, social justice

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3403 Climate Change Implications on Occupational Health and Productivity in Tropical Countries: Study Results from India

Authors: Vidhya Venugopal, Jeremiah Chinnadurai, Rebekah A. I. Lucas, Tord Kjellstrom, Bruno Lemke

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Introduction: The effects of climate change (CC) are largely discussed across the globe in terms of impacts on the environment and the general population, but the impacts on workers remain largely unexplored. The predicted rise in temperatures and heat events in the CC scenario have health implications on millions of workers in physically exerting jobs. The current health and productivity risks associated with heat exposures are characterized, future risk estimates as temperature rises and recommendations towards developing protective and preventive occupational health and safety guidelines for India are discussed. Methodology: Cross-sectional studies were conducted in several occupational sectors with workers engaged in moderate to heavy labor (n=1580). Quantitative data on heat exposures (WBGT°C), physiological heat strain indicators viz., Core temperature (CBT), Urine specific gravity (USG), Sweat rate (SwR) and qualitative data on heat-related health symptoms and productivity losses were collected. Data were analyzed for associations between heat exposures, health and productivity outcomes related to heat stress. Findings: Heat conditions exceeded the Threshold Limit Value (TLV) for safe manual work in 66% of the workers across several sectors (Avg.WBGT of 28.7°C±3.1°C). Widespread concerns about heat-related health outcomes (86%) were prevalent among workers exposed to high TLVs, with excessive sweating, fatigue and tiredness being commonly reported by workers. The heat stress indicators, core temperature (14%), Sweat rate (8%) and USG (9%), were above normal levels in the study population. A significant association was found between rise in Core Temperatures and WBGT exposures (p=0.000179) Elevated USG and SwR in the worker population indicate moderate dehydration, with potential risks of developing heat-related illnesses. In a steel industry with high heat exposures, an alarming 9% prevalence of kidney/urogenital anomalies was observed in a young workforce. Heat exposures above TLVs were associated with significantly increased odds of various adverse health outcomes (OR=2.43, 95% CI 1.88 to 3.13, p-value = <0.0001) and productivity losses (OR=1.79, 95% CI 1.32 to 2.4, p-value = 0.0002). Rough estimates for the number of workers who would be subjected to higher than TLV levels in the various RCP scenarios are RCP2.6 =79%, RCP4.5 & RCP6 = 81% and at RCP 8.5 = 85%. Rising temperatures due to CC has the capacity to further reduce already compromised health and productivity by subjecting the workers to increased heat exposures in the RCP scenarios are of concern for the country’s occupational health and economy. Conclusion: The findings of this study clearly identify that health protection from hot weather will become increasingly necessary in the Indian subcontinent and understanding the various adaptation techniques needs urgent attention. Further research with a multi-targeted approach to develop strategies for implementing interventions to protect the millions of workers is imperative. Approaches to include health aspects of climate change within sectoral and climate change specific policies should be encouraged, via a number of mechanisms, such as the “Health in All Policies” approach to avert adverse health and productivity consequences as climate change proceeds.

Keywords: heat stress, occupational health, productivity loss, heat strain, adverse health outcomes

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