Search results for: major adverse cardiac events
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 10340

Search results for: major adverse cardiac events

8960 Leveraging Remote Sensing Information for Drought Disaster Risk Management

Authors: Israel Ropo Orimoloye, Johanes A. Belle, Olusola Adeyemi, Olusola O. Ololade

Abstract:

With more than 100,000 orbits during the past 20 years, Terra has significantly improved our knowledge of the Earth's climate and its implications on societies and ecosystems of human activity and natural disasters, including drought events. With Terra instrument's performance and the free distribution of its products, this study utilised Terra MOD13Q1 satellite data to assess drought disaster events and its spatiotemporal patterns over the Free State Province of South Africa between 2001 and 2019 for summer, autumn, winter, and spring seasons. The study also used high-resolution downscaled climate change projections under three representative concentration pathways (RCP). Three future periods comprising the short (the 2030s), medium (2040s), and long term (2050s) compared to the current period are analysed to understand the potential magnitude of projected climate change-related drought. The study revealed that the year 2001 and 2016 witnessed extreme drought conditions where the drought index is between 0 and 20% across the entire province during summer, while the year 2003, 2004, 2007, and 2015 observed severe drought conditions across the region with variation from one part to the another. The result shows that from -24.5 to -25.5 latitude, the area witnessed a decrease in precipitation (80 to 120mm) across the time slice and an increase in the latitude -26° to -28° S for summer seasons, which is more prominent in the year 2041 to 2050. This study emphasizes the strong spatio-environmental impacts within the province and highlights the associated factors that characterise high drought stress risk, especially on the environment and ecosystems. This study contributes to a disaster risk framework to identify areas for specific research and adaptation activities on drought disaster risk and for environmental planning in the study area, which is characterised by both rural and urban contexts, to address climate change-related drought impacts.

Keywords: remote sensing, drought disaster, climate scenario, assessment

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8959 A Dimensional Approach to Family Involvement in Forensic Mental Health Settings - Prevention of the Systemic Replication of Abuse, Need for Accepted Falsehoods and Family Guilt and Shame

Authors: Katie E. Jennings

Abstract:

The interactions between family dynamics and environmental factors with mental health vulnerability in individuals are well known and are a theme for on-going research and debate. The impact upon mental health issues and forensic issues on family dynamics, experience, and emotional wellbeing cannot be over-Emphasised. For forensic patients with diagnosed mental disorders, these relationships and environments may have also been functionally linked to the development and maintenance of those disorders; with significant adverse childhood experiences being a common feature of many Patient’s histories. Mental health hospitals remove the patient from their home environments and provide treatment outside of these relationships and often outside of the home area. There is, therefore, a major focus on Services ensuring that patients are able to build and maintain relationships with family and friends, requiring services to involve families in Patients' care and treatment wherever possible. There are standards set by Government and clinical bodies that require absolute demonstration of the inclusion of family and friends in all aspects of the care and treatment of forensic patients. For some patients and family members, this push to take on a “role” in care can be unhelpful, extremely stressful, and has constant implications for the potential delicate reparation of relationships. Based on work undertaken for over 20 years in forensic mental health settings, this paper explores the positive psychology approach to a dimensional model to family inclusion in mental health care that learns from family court work and allows for the maintenance of relationships to be at both proximal and Distil levels; to prevent the replication of abuse, decrease the need for falsehoods and assist the recovery of all. The model is based on allowing families to choose to not be involved or be involved in different ways if this is seen to be more helpful. It also allows patients to choose the level of potential involvement that they would find helpful, and for this to be reviewed at a timeframe agreed by all parties, rather than when the next survey is due or the patient has a significant care meeting. This paper is significant as there is a lack of research to support services to use a positive psychology approach to work in this area, the assumption that being asked to be involved must be positive for all seems naïve at best for this patient group. Work relating to the psychology of family can significantly contribute to the development of knowledge in this area. The development of a dimensional model will support choice within families and assist in the development of more honest and open relationships.

Keywords: family dynamics, forensic, mental disorder, positive psychology

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8958 Medical Decision-Making in Advanced Dementia from the Family Caregiver Perspective: A Qualitative Study

Authors: Elzbieta Sikorska-Simmons

Abstract:

Advanced dementia is a progressive terminal brain disease that is accompanied by a syndrome of difficult to manage symptoms and complications that eventually lead to death. The management of advanced dementia poses major challenges to family caregivers who act as patient health care proxies in making medical treatment decisions. Little is known, however, about how they manage advanced dementia and how their treatment choices influence the quality of patient life. This prospective qualitative study examines the key medical treatment decisions that family caregivers make while managing advanced dementia. The term ‘family caregiver’ refers to a relative or a friend who is primarily responsible for managing patient’s medical care needs and legally authorized to give informed consent for medical treatments. Medical decision-making implies a process of choosing between treatment options in response to patient’s medical care needs (e.g., worsening comorbid conditions, pain, infections, acute medical events). Family caregivers engage in this process when they actively seek treatments or follow recommendations by healthcare professionals. Better understanding of medical decision-making from the family caregiver perspective is needed to design interventions that maximize the quality of patient life and limit inappropriate treatments. Data were collected in three waves of semi-structured interviews with 20 family caregivers for patients with advanced dementia. A purposive sample of 20 family caregivers was recruited from a senior care center in Central Florida. The qualitative personal interviews were conducted by the author in 4-5 months intervals. The ethical approval for the study was obtained prior to the data collection. Advanced dementia was operationalized as stage five or higher on the Global Deterioration Scale (GDS) (i.e., starting with the GDS score of five, patients are no longer able survive without assistance due to major cognitive and functional impairments). Information about patients’ GDS scores was obtained from the Center’s Medical Director, who had an in-depth knowledge of each patient’s health and medical treatment history. All interviews were audiotaped and transcribed verbatim. The qualitative data analysis was conducted to answer the following research questions: 1) what treatment decisions do family caregivers make while managing the symptoms of advanced dementia and 2) how do these treatment decisions influence the quality of patient life? To validate the results, the author asked each participating family caregiver if the summarized findings accurately captured his/her experiences. The identified medical decisions ranged from seeking specialist medical care to end-of-life care. The most common decisions were related to arranging medical appointments, medication management, seeking treatments for pain and other symptoms, nursing home placement, and accessing community-based healthcare services. The most challenging and consequential decisions were related to the management of acute complications, hospitalizations, and discontinuation of treatments. Decisions that had the greatest impact on the quality of patient life and survival were triggered by traumatic falls, worsening psychiatric symptoms, and aspiration pneumonia. The study findings have important implications for geriatric nurses in the context of patient/caregiver-centered dementia care. Innovative nursing approaches are needed to support family caregivers to effectively manage medical care needs of patients with advanced dementia.

Keywords: advanced dementia, family caregiver, medical decision-making, symptom management

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8957 3rd Generation Modular Execution: A Global Breakthrough in Modular Facility Construction System

Authors: Sean Bryner S. Rey, Eric Tanjutco

Abstract:

Modular execution strategies are performed to address the various challenges of any projects and are implemented on each project phase that covers Engineering, Procurement, Fabrication and Construction. It was until the recent years that the intent to surpass mechanical modularization approach were conceptualized to give solution to much greater demands of project components such as site location and adverse weather condition, material sourcing, construction schedule, safety risks and overall plot layout and allocation. The intent of this paper is to introduce the 3rd Generation Modular Execution with an overview of its advantages on project execution and will give emphasis on Engineering, Construction, Operation and Maintenance. Most importantly, the paper will present the key differentiator of 3rd Gen modular execution against other conventional project execution and the merits it bears for the industry.

Keywords: 3rd generation modular, process block, construction, operation & maintenance

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8956 Portrait of Musical Creativity or Indolence: A Critique of Unoka Character in Achebe’s Things Fall Apart

Authors: Ebim Matthew Abua

Abstract:

In Chinua Achebe’s Things Fall Apart (henceforth, TFA), the character Unoka is portrayed as a weakling and indolent person even when he was a creative artist, a talented musician, and a mathematician. His lack of achievement becomes the barometer for measuring his success. Right from time, music is considered to be of great significance because of its capacity to recreate and retell social events. To this end, music is both a social act and a creative art. As a social act, music is a discursive medium that exploits the dynamics of art in its evaluation of society. Music is so much a part of human existence that its presence in literature can help readers relate to fictional situations and characters. In this paper, the character Unoka is examined against the backdrop of his musical proclivities and his contributions to the overall development of TFA. Unfortunately, Achebe’s Things Fall Apart, a product of artistic creativity, portrays the personality of Unoka as lazy and uninspiring because he (Unoka) is a musician who is busy playing his flute and hardly doing anything productive. This paper is significant because it examines the literary and or linguistic depiction of Unoka and the aftermath of that depiction on the entire novel and, by extension, the larger society. Methodologically, this paper adopted the qualitative approach from the ethnography of communication (EOC), which is the analysis of communication within the wider context of the social and cultural practices and beliefs of the members of a particular culture or speech community. The aim of this qualitative research method includes the ability to discern which communication acts and/or codes are important to different groups, what types of meanings groups apply to different communication events, and how group members learn these codes to provide insight into particular communities. The study reveals that the people of Umuofia were mono-directional in their economy, and there was no room for diversification. One was either a farmer, or such a person was relegated to the background. Unoka, taking up a new challenge of diversifying the economy from the perspective of entertainment, was viewed as a misnomer. This study opens the door to other areas of studying Achebe’s epic novel apart from the critical works of literary artists that have been dished out over time.

Keywords: literature, popular culture, unoka, things fall apart

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8955 Analysing the Behaviour of Local Hurst Exponent and Lyapunov Exponent for Prediction of Market Crashes

Authors: Shreemoyee Sarkar, Vikhyat Chadha

Abstract:

In this paper, the local fractal properties and chaotic properties of financial time series are investigated by calculating two exponents, the Local Hurst Exponent: LHE and Lyapunov Exponent in a moving time window of a financial series.y. For the purpose of this paper, the Dow Jones Industrial Average (DIJA) and S&P 500, two of the major indices of United States have been considered. The behaviour of the above-mentioned exponents prior to some major crashes (1998 and 2008 crashes in S&P 500 and 2002 and 2008 crashes in DIJA) is discussed. Also, the optimal length of the window for obtaining the best possible results is decided. Based on the outcomes of the above, an attempt is made to predict the crashes and accuracy of such an algorithm is decided.

Keywords: local hurst exponent, lyapunov exponent, market crash prediction, time series chaos, time series local fractal properties

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8954 Modelling Forest Fire Risk in the Goaso Forest Area of Ghana: Remote Sensing and Geographic Information Systems Approach

Authors: Bernard Kumi-Boateng, Issaka Yakubu

Abstract:

Forest fire, which is, an uncontrolled fire occurring in nature has become a major concern for the Forestry Commission of Ghana (FCG). The forest fires in Ghana usually result in massive destruction and take a long time for the firefighting crews to gain control over the situation. In order to assess the effect of forest fire at local scale, it is important to consider the role fire plays in vegetation composition, biodiversity, soil erosion, and the hydrological cycle. The occurrence, frequency and behaviour of forest fires vary over time and space, primarily as a result of the complicated influences of changes in land use, vegetation composition, fire suppression efforts, and other indigenous factors. One of the forest zones in Ghana with a high level of vegetation stress is the Goaso forest area. The area has experienced changes in its traditional land use such as hunting, charcoal production, inefficient logging practices and rural abandonment patterns. These factors which were identified as major causes of forest fire, have recently modified the incidence of fire in the Goaso area. In spite of the incidence of forest fires in the Goaso forest area, most of the forest services do not provide a cartographic representation of the burned areas. This has resulted in significant amount of information being required by the firefighting unit of the FCG to understand fire risk factors and its spatial effects. This study uses Remote Sensing and Geographic Information System techniques to develop a fire risk hazard model using the Goaso Forest Area (GFA) as a case study. From the results of the study, natural forest, agricultural lands and plantation cover types were identified as the major fuel contributing loads. However, water bodies, roads and settlements were identified as minor fuel contributing loads. Based on the major and minor fuel contributing loads, a forest fire risk hazard model with a reasonable accuracy has been developed for the GFA to assist decision making.

Keywords: forest, GIS, remote sensing, Goaso

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8953 Study of Photonic Crystal Band Gap and Hexagonal Microcavity Based on Elliptical Shaped Holes

Authors: A. Benmerkhi, A. Bounouioua, M. Bouchemat, T. Bouchemat

Abstract:

In this paper, we present a numerical optical properties of a triangular periodic lattice of elliptical air holes. We report the influence of the ratio (semi-major axis length of elliptical hole to the filling ratio) on the photonic band gap. Then by using the finite difference time domain (FDTD) algorithm, the resonant wavelength of the point defect microcavities in a two-dimensional photonic crystal (PC) shifts towards the low wavelengths with significantly increased filing ratio. It can be noted that the Q factor is gradually changed to higher when the filling ratio increases. It is due to an increase in reflectivity of the PC mirror. Also we theoretically investigate the H1 cavity, where the value of semi-major axis (Rx) of the six holes surrounding the cavity are fixed at 0.5a and the Rx of the two edge air holes are fixed at the optimum value of 0.52a. The highest Q factor of 4.1359 × 106 is achieved at the resonant mode located at λ = 1.4970 µm.

Keywords: photonic crystal, microcavity, filling ratio, elliptical holes

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8952 The Future of Food and Agriculture in India: Trends and Challenges

Authors: Vishwambhar Prasad Sati

Abstract:

India’s economy is agriculture dominated. About 70% of the total population depends on practicing agriculture. Out of an estimated 140.3 million ha net cultivated area, 79.44 million ha (57%) is rain-fed, contributing 44% of the total food grain production. Meanwhile, India ranks second and shares 11.3% of the arable land of the world. It means that India has a high potential to harness agricultural resources for present and future food security. However, about 21.9% of people are living below the poverty line, and similarly, a large number of people are deprived or insecure about food. This situation is most critical in rural areas, where about 70% population lives. The study examines the present status, future trends, and challenges of food and agriculture in India. Time series data of the last three decades was gathered from secondary sources on area, production, and yield of crops; irrigated area; production of major crops; area, production, and yield of crops in the major food-producing states of India; food storage and poverty. The data were analyzed using descriptive statistics, correlation methods, and a regression model. State-level data on area, production, and yield of crops and irrigation facilities were indexed into levels, and the potentials of food production in the major food-producing states were observed. It was noted that the progressive growth rate of food production is higher than the population, which means that food is enough to feed the population; however, it is not accessible to all optimally because of wastage, leakage, lack of food storage, and proper distribution of food. If food is stored and distributed properly, there would not be any food shortage in India, the study revealed.

Keywords: agriculture, food production, population growth, poverty, future trends

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8951 Fight the Burnout: Phase Two of a NICU Nurse Wellness Bundle

Authors: Megan Weisbart

Abstract:

Background/Significance: The Intensive Care Unit (ICU) environment contributes to nurse burnout. Burnout costs include decreased employee compassion, missed workdays, worse patient outcomes, diminished job performance, high turnover, and higher organizational cost. Meaningful recognition, nurturing of interpersonal connections, and mindfulness-based interventions are associated with decreased burnout. The purpose of this quality improvement project was to decrease Neonatal ICU (NICU) nurse burnout using a Wellness Bundle that fosters meaningful recognition, interpersonal connections and includes mindfulness-based interventions. Methods: The Professional Quality of Life Scale Version 5 (ProQOL5) was used to measure burnout before Wellness Bundle implementation, after six months, and will be given yearly for three years. Meaningful recognition bundle items include Online submission and posting of staff shoutouts, recognition events, Nurses Week and Unit Practice Council member gifts, and an employee recognition program. Fostering of interpersonal connections bundle items include: Monthly staff games with prizes, social events, raffle fundraisers, unit blog, unit wellness basket, and a wellness resource sheet. Quick coherence techniques were implemented at staff meetings and huddles as a mindfulness-based intervention. Findings: The mean baseline burnout score of 14 NICU nurses was 20.71 (low burnout). The baseline range was 13-28, with 11 nurses experiencing low burnout, three nurses experiencing moderate burnout, and zero nurses experiencing high burnout. After six months of the Wellness Bundle Implementation, the mean burnout score of 39 NICU nurses was 22.28 (low burnout). The range was 14-31, with 22 nurses experiencing low burnout, 17 nurses experiencing moderate burnout, and zero nurses experiencing high burnout. Conclusion: A NICU Wellness Bundle that incorporated meaningful recognition, fostering of interpersonal connections, and mindfulness-based activities was implemented to improve work environments and decrease nurse burnout. Participation bias and low baseline response rate may have affected the reliability of the data and necessitate another comparative measure of burnout in one year.

Keywords: burnout, NICU, nurse, wellness

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8950 A Critique of Kenya’s Obsession with Ngugi Winning Literature Nobel Prize

Authors: Alexander Ernesto Khamala Opicho

Abstract:

The month of October in Kenya is full of events and literary speculations. For the past five years it has all been about Ngugi wa Thiong’o a Kenyan novelist winning the Nobel Prize. This goes on with a dint of self senselessness among the people involved. This paper surveys why some Kenyans are keen on Ngugi winning Nobel Prize for literature, and it also shows where and why they are wrong. The paper will end up with a comment on the proper position of African or Kenyan literature in the global literary citizenship.

Keywords: literature, onamastics, cultural Darwinism, obsession, Nobel Prize, denotation

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8949 Vertical and Horizantal Distribution Patterns of Major and Trace Elements: Surface and Subsurface Sediments of Endhorheic Lake Acigol Basin, Denizli Turkey

Authors: M. Budakoglu, M. Karaman

Abstract:

Lake Acıgöl is located in area with limited influences from urban and industrial pollution sources, there is nevertheless a need to understand all potential lithological and anthropogenic sources of priority contaminants in this closed basin. This study discusses vertical and horizontal distribution pattern of major, trace elements of recent lake sediments to better understand their current geochemical analog with lithological units in the Lake Acıgöl basin. This study also provides reliable background levels for the region by the detailed surfaced lithological units data. The detail results of surface, subsurface and shallow core sediments from these relatively unperturbed ecosystems, highlight its importance as conservation area, despite the high-scale industrial salt production activity. While P2O5/TiO2 versus MgO/CaO classification diagram indicate magmatic and sedimentary origin of lake sediment, Log(SiO2/Al2O3) versus Log(Na2O/K2O) classification diagrams express lithological assemblages of shale, iron-shale, vacke and arkose. The plot between TiO2 vs. SiO2 and P2O5/TiO2 vs. MgO/CaO also supports the origin of the primary magma source. The average compositions of the 20 different lithological units used as a proxy for geochemical background in the study area. As expected from weathered rock materials, there is a large variation in the major element content for all analyzed lake samples. The A-CN-K and A-CNK-FM ternary diagrams were used to deduce weathering trends. Surface and subsurface sediments display an intense weathering history according to these ternary diagrams. The most of the sediments samples plot around UCC and TTG, suggesting a low to moderate weathering history for the provenance. The sediments plot in a region clearly suggesting relative similar contents in Al2O3, CaO, Na2O, and K2O from those of lithological samples.

Keywords: Lake Acıgöl, recent lake sediment, geochemical speciation of major and trace elements, heavy metals, Denizli, Turkey

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8948 Detecting Trends in Annual Discharge and Precipitation in the Chott Melghir Basin in Southeastern Algeria

Authors: M. T. Bouziane, A. Benkhaled, B. Achour

Abstract:

In this study, data from 30 catchments in the Chott Melghir basin in the semiarid region of southern East Algeria were analyzed to investigate changes in annual discharge, annual precipitation over the 1965-2005 period. These data were analyzed with the aid of Kendall test trend and regression analysis. The results indicate that the major variations in all catchments discharge in Chott Melghir correspond well to the precipitation. Changes in total annual discharge of Chott Melghir were lower than changes in annual precipitation. Annual precipitation decreased by 66 percent and annual discharge decreased by 4 percent. No significant trend is detected for annual discharge and precipitation at major catchments up to 95% confidence level. The decreasing trend in Chott Melghir discharge is mainly attributed to the decrease of precipitation.

Keywords: trends, climate change, precipitation, discharge, Kendall test, regression analysis, Chott Melghir catchments

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8947 Consumer Over-Indebtedness in Germany: An Investigation of Key Determinants

Authors: Xiaojing Wang, Ann-Marie Ward, Tony Wall

Abstract:

The problem of over-indebtedness has increased since deregulation of the banking industry in the 1980s, and now it has become a major problem for most countries in Europe, including Germany. Consumer debt issues have attracted not only the attention of academics but also government and debt counselling institutions. Overall, this research aims to contribute to the knowledge gap regarding the causes of consumer over-indebtedness in Germany and to develop predictive models for assessing consumer over-indebtedness risk at consumer level. The situation of consumer over-indebtedness is serious in Germany. The relatively high level of social welfare support in Germany suggests that consumer debt problems are caused by other factors, other than just over-spending and income volatility. Prior literature suggests that the overall stability of the economy and level of welfare support for individuals from the structural environment contributes to consumers’ debt problems. In terms of cultural influence, the conspicuous consumption theory in consumer behaviour suggests that consumers would spend more than their means to be seen as similar profiles to consumers in a higher socio-economic class. This results in consumers taking on more debt than they can afford, and eventually becoming over-indebted. Studies have also shown that financial literacy is negatively related to consumer over-indebtedness risk. Whilst prior literature has examined structural and cultural influences respectively, no study has taken a collective approach. To address this gap, a model is developed to investigate the association between consumer over-indebtedness and proxies for influences from the structural and cultural environment based on the above theories. The model also controls for consumer demographic characteristics identified as being of influence in prior literature, such as gender and age, and adverse shocks, such as divorce or bereavement in the household. Benefiting from SOEP regional data, this study is able to conduct quantitative empirical analysis to test both structural and cultural influences at a localised level. Using German Socio-Economic Panel (SOEP) study data from 2006 to 2016, this study finds that social benefits, financial literacy and the existence of conspicuous consumption all contribute to being over-indebted. Generally speaking, the risk of becoming over-indebted is high when consumers are in a low-welfare community, have little awareness of their own financial situation and always over-spend. In order to tackle the problem of over-indebtedness, countermeasures can be taken, for example, increasing consumers’ financial awareness, and the level of welfare support. By analysing causes of consumer over-indebtedness in Germany, this study also provides new insights on the nature and underlying causes of consumer debt issues in Europe.

Keywords: consumer, debt, financial literacy, socio-economic

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8946 Comparation of Essential Oils Composition from the Leaves and Flowers of Salvia pratensis L.

Authors: Valerija Dunkić, Nada Bezić

Abstract:

Salvia is a genus of the well-known medicinal plant of Lamiaceae family and growing wild throughout the world. This abstract reports the comparation of the essential oils from leaves and flowers composition of Salvia pratensis L. from mountain Velebit, Croatia. Water distilled essential oils from aerial parts of investigation plant have been analysed by GC and GC/MS using VF-5ms capillary column. Fifty-three constituents, representing 99.4% of the leaf oil composition; 51 constituents, representing 86.8% of the flower oil composition. Essential oil yield varied from 0.9% to 1.3% in the leaf and flower parts of the plant. The flower essential oil was characterized by a high concentration of E-caryophyllene (21.9%) and germacrene D (10.2%). Major constituents of the leaf oil were linalool (17.7%), linalool acetate (15.3%) and limonene (9.8%). The comparative results clearly indicated that the leaf and flower oil compositions of S. pratensis were quite different in terms of major components content. The present study gives additional knowledge about secondary metabolites contents on the genus Salvia.

Keywords: essential oil, leaf, flower, Salvia pratensis L.

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8945 An Assessment of Potentials, Challenges, and Opportunities of Ethiopian Cultural Centers for Tourism Product Development

Authors: Berie Abebe Getahun

Abstract:

The tourism sector has been identified by the Ethiopian government as one of the priority economic sectors and planned to make Ethiopia among the top five African destinations by 2020. It is obvious international tourism demand for Ethiopia lags behind other African countries like South Africa, Egypt, Morocco, Tanzania, and Kenya. Meanwhile, the number of international tourists’ arrival to Ethiopia increases continuously. The main purpose of this study was to find out potentials, challenges, and opportunities of Ethiopian Cultural Center for tourism product development. Therefore, an attempt has been made to identify potentials over which tourism product development can be enhanced, and opportunities that promote tourism product development in Ethiopia. To achieve this objective, data have been collected by using observation, interview and focus group discussion with selected informants working the ministry of tourism and culture. The collected data has been analyzed by transcribing materials, and by using thematic analysis method based on the research objective. Likewise, the analyzed data has been discussed in the context of prevailing literature. As revealed in finding, Ethiopian cultural center has untapped potential for tourism product development that includes: meetings, incentives, conferences, events, availability of concerned stakeholders and demand of visitors. On the other hand, lack of awareness about tourism product development, financial constraints, skilled manpower, absence of tour guiding service and interpretation of heritages have been identified as the major challenges that hindering tourism product development in the cultural center. Moreover, the growth of domestic tourism, distinctive presence and rich culture of Ethiopia, and policy of Ethiopia that promotes the growth and preservation of indigenous cultures are deemed important opportunities for tourism product development in the country. And lastly, conducting a research based on tourism product development, reviewing the existing marketing and promotion strategies, training manpower, working harmoniously with the concerned stakeholders, and a careful examination of opportunities present in order to best utilize resources were implications drawn for future intervention.

Keywords: challenges and opportunities of tourism, Ethiopian tourism potential, tourism product, tourism product development

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8944 Major Gullies Erosion Sites and Volume of Soil Loss in Edo State, Nigeria

Authors: Augustine Osayande

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This research is on Major Gullies Erosion Sites and Volume of Soil Loss in Edo State, Nigeria. The primary objective was to identify notable gullies sites and quantify the volume of soil loss in the study area. Direct field observation and measurement of gullies dimensions was done with the help of research assistants using a measuring tape, Camera and 3percent accuracy Global Positioning System (GPS). The result revealed that notable gullies in the area have resulted in the loss of lives and properties, destruction of arable lands and wastage of large areas of usable lands. Gullies in Edo North have Mean Volume of Soil Loss of 614, 763.33 m³, followed by Edo South with 79,604.76 m³ and Edo Central is 46,242.98 m³ and as such an average of 1,772, 888.7m3 of soil is lost annually in the study area due to gully erosion problem. The danger of gully erosion in helpless regions like Edo State called for urgent remedies in order to arrest the further loss of soil, buildings and other properties.

Keywords: Edo, magnitude, gully, volume, soil, sloss

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8943 Appraisal of Conservation Strategies of Veligonda Forest Range of Eastern Ghats, Andhra Pradesh, India

Authors: Khasim Munir Bhasha Shaik

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Veligonda and adjoining hill range spread along about 170 Km North to South in Kadapa and Nellore Districts stretching a little further into Prakasam District. The latitude in general ranges up to 1000m. The forests are generally dry deciduous type. Veligonda and adjoining hill ranges comprise of Palakonda, Seshachalam, Lankamala and the terminal part of Nallamalais from mid-region of Southern Eastern Ghats. The Veligonda range which separates the Nellore district from Kadapa and Kurnool is the backbone of the Eastern Ghats, starting from Nagari promontory in Chittoor district. It runs in a northerly direction along the western border of the Nellore district, with a raising elevation of 3,626 ft at Penchalakona in Raipur thaluk. Veligonda hill ranges are high in altitude and have deep valleys. Among the Veligondas range of hills the Durgam in Venkatagiri range and Penchalakona are the most prominent and are situated 914 meters above mean sea level. It has more than 3000 species of plants along with 500 animal species. The unique specialty of this region is the presence of Pterocarpus santalinus(endangered) and Santalum album (vulnerable). In the present study, an attempt is made to assess the efforts that are going on to conserve the biodiversity of flora and fauna of this region. Various conservation strategies were suggested to protect the biodiversity and richness of Veligonda forest, hill region of Eastern Ghats of Andhra Pradesh. The major threats and the reasons for the dwindling species richness are poor rainfall, adverse climatic conditions, robbery of Red sanders and poaching of animals by the local tribals. Efforts are to be made to conserve some of the animals by both in situ and ex-situ methods. More awareness is to be developed among the local communities who are dwelling in the vicinity and importance of conservation is to be emphasized to them. Anthropogenic attachments are to be made by introducing more numbers of sacred groves. Gross enforcement of law is to be made to protect the various forest resources in this area. The important species with the medicinal values are to be identified. It was found that two important wildlife sanctuaries named Sri Lankamalleswarawildlife sanctuary and Sripenusila Narasimha wildlife sanctuary are working for the comprehensive conservation of the environment in this area. Apart from this more than 38 important sacred grooves are there where the plants and animals are protected by local Yanadi and other communities.

Keywords: biodiversity, wild life sanctuary, habitat destruction, eastern Ghats

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8942 Communicative Language between Doctors and Patients in Healthcare

Authors: Anita Puspawati

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A failure in obtaining informed consent from patient occurs because there is not effective communication skill in doctors. Therefore, the language is very important in communication between doctor and patient. This study uses descriptive analysis method, that is a method used mainly in researching the status of a group of people, an object, a condition, a system of thought or a class of events in the present. The result of this study indicates that the communicative language between doctors and patients will increase the trust of patients to their doctors and accordingşy, patients will provide the informed consent voluntarily.

Keywords: communicative, language, doctor, patient

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8941 Pregnancy Outcome in Women with HIV Infection from a Tertiary Care Centre of India

Authors: Kavita Khoiwal, Vatsla Dadhwal, K. Aparna Sharma, Dipika Deka, Plabani Sarkar

Abstract:

Introduction: About 2.4 million (1.93 - 3.04 million) people are living with HIV/AIDS in India. Of all HIV infections, 39% (9,30,000) are among women. 5.4% of infections are from mother to child transmission (MTCT), 25,000 infected children are born every year. Besides the risk of mother to child transmission of HIV, these women are at risk of the higher adverse pregnancy outcome. The objectives of the study were to compare the obstetric and neonatal outcome in women who are HIV positive with low-risk HIV negative women and effect of antiretroviral drugs on preterm birth and IUGR. Materials and Methods: This is a retrospective case record analysis of 212 HIV-positive women delivering between 2002 to 2015, in a tertiary health care centre which was compared with 238 HIV-negative controls. Women who underwent medical termination of pregnancy and abortion were excluded from the study. Obstetric outcome analyzed were pregnancy induced hypertension, HIV positive intrauterine growth restriction, preterm birth, anemia, gestational diabetes and intrahepatic cholestasis of pregnancy. Neonatal outcome analysed were birth weight, apgar score, NICU admission and perinatal transmission.HIV-positiveOut of 212 women, 204 received antiretroviral therapy (ART) to prevent MTCT, 27 women received single dose nevirapine (sdNVP) or sdNVP tailed with 7 days of zidovudine and lamivudine (ZDV + 3TC), 15 received ZDV, 82 women received duovir and 80 women received triple drug therapy depending upon the time period of presentation. Results: Mean age of 212 HIV positive women was 25.72+3.6 years, 101 women (47.6 %) were primigravida. HIV positive status was diagnosed during pregnancy in 200 women while 12 women were diagnosed prior to conception. Among 212 HIV positive women, 20 (9.4 %) women had preterm delivery (< 37 weeks), 194 women (91.5 %) delivered by cesarean section and 18 women (8.5 %) delivered vaginally. 178 neonates (83.9 %) received exclusive top feeding and 34 neonates (16.03 %) received exclusive breast feeding. When compared to low risk HIV negative women (n=238), HIV positive women were more likely to deliver preterm (OR 1.27), have anemia (OR 1.39) and intrauterine growth restriction (OR 2.07). Incidence of pregnancy induced hypertension, diabetes mellitus and ICP was not increased. Mean birth weight was significantly lower in HIV positive women (2593.60+499 gm) when compared to HIV negative women (2919+459 gm). Complete follow up is available for 148 neonates till date, rest are under evaluation. Out of these 7 neonates found to have HIV positive status. Risk of preterm birth (P value = 0.039) and IUGR (P value = 0.739) was higher in HIV positive women who did not receive any ART during pregnancy than women who received ART. Conclusion: HIV positive pregnant women are at increased risk of adverse pregnancy outcome. Multidisciplinary team approach and use of highly active antiretroviral therapy can optimize the maternal and perinatal outcome.

Keywords: antiretroviral therapy, HIV infection, IUGR, preterm birth

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8940 The Effect of Surgical Intervention on Pediatric and Adolescent Obstructive Sleep Apnea Syndrome

Authors: Ching-Yi Yiu, Hui-Chen Hsu

Abstract:

Objectives: Obstructive sleep apnea syndrome (OSAS) is a popular problem in the modern society. It usually leads to sleep disorder, excessive daytime sleepiness and associated with cardiovascular diseases, cognitive dysfunction and even death. The nonsurgical therapies include continuous positive airway pressure (CPAP), diet and oral appliances. The surgical approaches have nasal surgery, tonsillectomy, adenoidectomy, uvulopalatopharyngoplasty (UPPP) and transoral robotic surgery (TORS).We compare the impact of surgical treatments on these kinds of patients. Methods: Between January 2018 to September 2022, We have enrolled 125 OSAS patients including 82 male and 43 female in Chi Mei Medical Center, Liouying, Taiwan. The age distribution from 6 to 71 years old (y/o) with mean age 36.1 y/o. The averaged body mass index (BMI) is 25 kg/m2 in male and 25.5 kg/m2 in female. In this cohort, we evaluated their upper airway obstruction sites with nasopharyngoscopy and scheduled a planned surgery. Some of cases received polysomnography (PSG) preoperatively, the averaged apnea-hypopnea index (AHI) is 37.7 events/hour. We have 68 patients received tonsillectomy, 9 received UPPP, 42 received UPPP and septomeatoplasty (SMP) and 6 received adenoidectomy and tonsillectomy (A and T). The subjective daytime sleepiness was evaluated with the Epworth sleepiness scale (ESS). Results: In the 68 tonsillectomy group, the averaged BMI is 24.9 kg/m2. In the UPPP group, the averaged BMI is 28.9 kg/m2. In UPPP and SMP group, the averaged BMI is 27.9 kg/m2. In the A and T group, the averaged BMI is 17.2 kg/m2. The reduction of AHI less than 20 is 58% postoperatively. The ESS reduced from 10.9 to 4.9 after surgery. Conclusion: Obstructive sleep apnea syndrome is a common upper airway disturbance in the general population. The prevalence rate is ranging high depending on different regions, age, sex and race. It leads to severe morbidity and mortality including car accident, stroke, nocturnal desaand sudden death and should be considered to be a major public health problem. The CPAP is effective to improve daytime sleepiness but the long-term compliance is low. The surgical treatment with different modalities can produce 50% decrease in AHI and ESS after surgery in the 6 to 12 months short-term period.

Keywords: apnea-hypopnea index, obstructive sleep apnea syndrome, polysomnography, uvulopalatopharyngoplasty

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8939 Cytotoxic Activity Of Major Iridoids From Barleria Trispinosa (Forssk.) Vahl. Growing In Saudi Arabia

Authors: Hamza Assiry, Gamal A. Mohamed, Sabrin R. M. Ibrahim, Hossam M. Abdallah

Abstract:

Chemical investigation of the aerial parts of Barleria trispinosa(Forssk.) Vahl. resulted in isolation of four major iridoids that were identified as 6,8-O,O-diacetylshanhiside methyl ester (acetyl barlerin) (1), 8-O-acetylshanzhiside methyl ester (barlerin) (2), shanzhiside methyl ester (3), and 6- ⍺ -L-rhamnopyranosyl-8-O-acetylshanzihiside methyl ester (4). The isolated compounds were confirmed by detailed one and two-dimensional NMR. Isolated compounds were tested for their cytotoxic activity on breast cancer (MCF-7, MDA-MB-231) and colon cancer (LS174T) cell linesusing sulphorhodamine B (SRB) assay. It is noteworthy that compound 1 demonstrated a significant cytotoxic potential towards MDA-MB-231 cell line with IC5016.7 ± 2.7µg / mL compared to doxorubicin whereas compounds 2, showed moderate cytotoxic potential with IC5021.2 ± 1.9µg / mL on MCF-7. The other compounds showed moderate activity on the tested cell lines.

Keywords: acanthaceae, cytotoxicity, metabolites, barleria trispinosa

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8938 Environmental Degradation in Niger-Delta and Sustainable Development in Nigeria: Issues for Consideration

Authors: Peter Okpamen

Abstract:

The issue of environmental degradation in Nigeria is of serious concern. The colonial period brought a major change in environmental awareness and relationship with the environment. This period introduced a model of development, the major thrust of which was the exploration and transformation of natural and human resources for the benefit of the colonial masters. There is abundant evidence in the literature that there are various manifestations of environmental degradation in Nigeria, which have resulted in the various problems found throughout the Nigeria national space. The idea of the environment acting as a constraint to the growth of human activity has given way to the contrary. Environmental education, going by the literature, exists at the primary, secondary and tertiary institutions. In short, the 1st National conference on environmental education gave several suggestions on how it could be realised. Thus, to realise sustainable environmental development we need to accelerate the process of providing basic education for both the old and young. Environmental education should cover the whole federation, and resources should be made available for the training of environmental education teachers and research into environmental education for the development of appropriate learning resources.

Keywords: degradation, development, education, environment, sustainable

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8937 Consumption Habits of Low-Fat Plant Sterol-Enriched Yoghurt Enriched with Phytosterols

Authors: M. J. Reis Lima, J. Oliveira, A. C. Sousa Pereira, M. C. Castilho, E. Teixeira-Lemos

Abstract:

The increasing interest in plant sterol enriched foods is due to the fact that they reduce blood cholesterol concentrations without adverse side effects. In this context, enriched foods with phytosterols may be helpful in protecting population against atherosclerosis and cardiovascular diseases. The aim of the present work was to evaluate in a population of Viseu, Portugal, the consumption habits low-fat, plant sterol-enriched yoghurt. For this study, 577 inquiries were made and the sample was randomly selected for people shopping in various supermarkets. The preliminary results showed that the biggest consumers of these products were women aged 45 to 65 years old. Most of the people who claimed to buy these products consumed them once a day. Also, most of the consumers under antidyslipidemic therapeutics noticed positive effects on hypercholesterolemia.

Keywords: consumption habits, fermented milk, functional foods, low fat, phytosterols

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8936 Effectiveness of Public Health Laws and Study of Social Aspects: With Special Reference to India

Authors: Arun Karoriya, Mrinal Agrawal

Abstract:

Health is one of the basic requirements of human being. And today India is facing a major degradation of health at every age group. As society evolves and flourishes, there are different types of rules, norms, standards which are required to control the conduct of the human being for its well-being and growth. Right to health is one of those aspects that can be counted, discovered and examined under the purview of constitutional provisions of India. The condition of health is at downfall despite the fact that there are several policies framed by the government. There is an urgent call for rigid public health laws to ensure safe and disease free society. The effectiveness of health law has to be examined by keeping in mind that it is hampering growth and economy and society establishment. Health in any society is a main social aspect as it plays a major role for economic development. The multidimensional approach to determine it is by discussing i) rational selection and use of medicines ii) sustainable adequate financing iii) affordable prices iv)reliable health and supply systems.

Keywords: degradation, flourish, multidimensional, policies

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8935 Modeling and Design of Rectenna for Low Power Medical Implants

Authors: Madhav Pant, Khem N. Poudel

Abstract:

Wireless power transfer is continuously becoming more powerful and compact in medical implantable devices and the wide range of applications. A rectenna is designed for wireless power transfer technique that can be applied to medical implant devices. The experiment is performed using ANSYS HFSS, a full wave electromagnetic simulation. The dipole antenna combinations operating at 2.4 GHz are used for wireless power transfer and the maximum DC voltage reception by the implant considering International Commission on Non-Ionizing Radiation Protection (ICNIRP) regulation. The power receiving dipole antenna is placed inside the cylindrical geometry having the similar properties of the human body at the frequency of 2.4 GHz. Our design can provide the power at the depth of 5 mm skin and 5mm of bone for the implant. The voltage doubler/quadrupler rectifier in ANSYS Simplorer is used to calculate the exact DC current utilized by implant inside the human body. The qualitative design and analysis of this wireless power transfer method could also be used for other biomedical implants systems such as cardiac pacemaker, insulin pump, and retinal implants.

Keywords: dipole antenna, medical implants, wireless power transfer, rectifier

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8934 Genetics of Pharmacokinetic Drug-Drug Interactions of Most Commonly Used Drug Combinations in the UK: Uncovering Unrecognised Associations

Authors: Mustafa Malki, Ewan R. Pearson

Abstract:

Tools utilized by health care practitioners to flag potential adverse drug reactions secondary to drug-drug interactions ignore individual genetic variation, which has the potential to markedly alter the severity of these interactions. To our best knowledge, there have been limited published studies on the impact of genetic variation on drug-drug interactions. Therefore, our aim in this project is the discovery of previously unrecognized, clinically important drug-drug-gene interactions (DDGIs) within the list of most commonly used drug combinations in the UK. The UKBB database was utilized to identify the top most frequently prescribed drug combinations in the UK with at least one route of interaction (over than 200 combinations were identified). We have recognised 37 common and unique interacting genes considering all of our drug combinations. Out of around 600 potential genetic variants found in these 37 genes, 100 variants have met the selection criteria (common variant with minor allele frequency ≥ 5%, independence, and has passed HWE test). The association between these variants and the use of each of our top drug combinations has been tested with a case-control analysis under the log-additive model. As the data is cross-sectional, drug intolerance has been identified from the genotype distribution as presented by the lower percentage of patients carrying the risky allele and on the drug combination compared to those free of these risk factors and vice versa with drug tolerance. In GoDARTs database, the same list of common drug combinations identified by the UKBB was utilized here with the same list of candidate genetic variants but with the addition of 14 new SNPs so that we have a total of 114 variants which have met the selection criteria in GoDARTs. From the list of the top 200 drug combinations, we have selected 28 combinations where the two drugs in each combination are known to be used chronically. For each of our 28 combinations, three drug response phenotypes have been identified (drug stop/switch, dose decrease, or dose increase of any of the two drugs during their interaction). The association between each of the three phenotypes belonging to each of our 28 drug combinations has been tested against our 114 candidate genetic variants. The results show replication of four findings between both databases : (1) Omeprazole +Amitriptyline +rs2246709 (A > G) variant in CYP3A4 gene (p-values and ORs with the UKBB and GoDARTs respectively = 0.048,0.037,0.92,and 0.52 (dose increase phenotype)) (2) Simvastatin + Ranitidine + rs9332197 (T > C) variant in CYP2C9 gene (0.024,0.032,0.81, and 5.75 (drug stop/switch phenotype)) (3) Atorvastatin + Doxazosin + rs9282564 (T > C) variant in ABCB1 gene (0.0015,0.0095,1.58,and 3.14 (drug stop/switch phenotype)) (4) Simvastatin + Nifedipine + rs2257401 (C > G) variant in CYP3A7 gene (0.025,0.019,0.77,and 0.30 (drug stop/switch phenotype)). In addition, some other non-replicated, but interesting, significant findings were detected. Our work also provides a great source of information for researchers interested in DD, DG, or DDG interactions studies as it has highlighted the top common drug combinations in the UK with recognizing 114 significant genetic variants related to drugs' pharmacokinetic.

Keywords: adverse drug reactions, common drug combinations, drug-drug-gene interactions, pharmacogenomics

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8933 Coloured Petri Nets Model for Web Architectures of Web and Database Servers

Authors: Nidhi Gaur, Padmaja Joshi, Vijay Jain, Rajeev Srivastava

Abstract:

Web application architecture is important to achieve the desired performance for the application. Performance analysis studies are conducted to evaluate existing or planned systems. Web applications are used by hundreds of thousands of users simultaneously, which sometimes increases the risk of server failure in real time operations. We use Coloured Petri Net (CPN), a very powerful tool for modelling dynamic behaviour of a web application system. CPNs extend the vocabulary of ordinary Petri nets and add features that make them suitable for modelling large systems. The major focus of this work is on server side of web applications. The presented work focuses on modelling restructuring aspects, with major focus on concurrency and architecture, using CPN. It also focuses on bringing out the appropriate architecture for web and database servers given the number of concurrent users.

Keywords: coloured Petri Nets (CPNs), concurrent users, per- formance modelling, web application architecture

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8932 Project Abandonment and Its Effect on Host Community: Case Study of Ajaokuta Steel Project, Nigeria

Authors: A. A. Omonori, K. T. Alade, A. F. Lawal

Abstract:

This research was conducted to identify the causes of project abandonment in Nigeria and the effect it has on the host community. The aim of the research was to identify the causes and effects of project failure and abandonment. Project abandonment is a major course of concern in the country as different projects fail and are abandoned at various levels. These projects do not fulfill the purpose for which they were initiated. This is the absolute definition of failure and hence the selection of the Ajaokuta Steel Project as an interesting case study and a typical example of project failure and abandonment. This has been done by conducting field study through the administration of questionnaires. This study was carried out on the Ajaokuta Steel Project to investigate the causes of the abandonment of the project and the effects it has had on the people of Ajaokuta community. Qualitative method of data analysis was used to analyze the findings through frequency tables and ranking. This study brought to light the major factors that led to the abandonment of the Ajaokuta Steel Project. The effects the abandonment of the project has had on the immediate community were identified and recommendations made to prevent the menace of Project abandonment.

Keywords: abandonment, case-study, Nigeria, project

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8931 Assessment of the Environmental Compliance at the Jurassic Production Facilities towards HSE MS Procedures and Kuwait Environment Public Authority Regulations

Authors: Fatemah Al-Baroud, Sudharani Shreenivas Kshatriya

Abstract:

Kuwait Oil Company (KOC) is one of the companies for gas & oil production in Kuwait. The oil and gas industry is truly global; with operations conducted in every corner of the globe, the global community will rely heavily on oil and gas supplies. KOC has made many commitments to protect all due to KOC’s operations and operational releases. As per KOC’s strategy, the substantial increase in production activities will bring many challenges in managing various environmental hazards and stresses in the company. In order to handle those environmental challenges, the need of implementing effectively the health, safety, and environmental management system (HSEMS) is significant. And by implementing the HSEMS system properly, the environmental aspects of the activities, products, and services were identified, evaluated, and controlled in order to (i) Comply with local regulatory and other obligatory requirements; (ii) Comply with company policy and business requirements; and (iii) Reduce adverse environmental impact, including adverse impact to company reputation. Assessments for the Jurassic Production Facilities are being carried out as a part of the KOC HSEMS procedural requirement and monitoring the implementation of the relevant HSEMS procedures in the facilities. The assessments have been done by conducting series of theme audits using KOC’s audit protocol at JPFs. The objectives of the audits are to evaluate the compliance of the facilities towards the implementation of environmental procedures and the status of the KEPA requirement at all JPFs. The list of the facilities that were covered during the theme audit program are the following: (1) Jurassic Production Facility (JPF) – Sabriya (2) Jurassic Production Facility (JPF) – East Raudhatian (3) Jurassic Production Facility (JPF) – West Raudhatian (4)Early Production Facility (EPF 50). The auditing process comprehensively focuses on the application of KOC HSE MS procedures at JPFs and their ability to reduce the resultant negative impacts on the environment from the operations. Number of findings and observations were noted and highlighted in the audit reports and sent to all concerned controlling teams. The results of these audits indicated that the facilities, in general view, were in line with KOC HSE Procedures, and there were commitments in documenting all the HSE issues in the right records and plans. Further, implemented several control measures at JPFs that minimized/reduced the environmental impact, such as SRU were installed for sulphur recovery. Future scope and monitoring audit after a sufficient period of time will be carried out in conjunction with the controlling teams in order to verify the current status of the recommendations and evaluate the contractors' performance towards the required actions in preserving the environment.

Keywords: assessment of the environmental compliance, environmental and social impact assessment, kuwait environment public authority regulations, health, safety and environment management procedures, jurassic production facilities

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