Search results for: quality and qualitative education

Authors: Shalinawati Ramli, Khairani Omar, Nurul Azmawati Mohamed, Zarini Ismail, Nur Syahrina Rahim, Nurul Hayati Chamhuri

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Medical doctors’ work to prevent, diagnose, treat diseases, disorders, and injuries as well as prescribing medication. Many people are attracted to this profession because it gives them the opportunity to help others. Doctors’ improve quality of life by providing advice, healing physical ailments and performing complex surgeries. Medicine is a profession in which dedication to the wellbeing of others is of paramount importance. Balancing the requirements of work and personal life can be a struggle as the demand of work as a doctors’ is great. Perception and expectation of medical students regarding the lifestyle of doctors’ is important to ensure that they had made the right career choice. Thus, the aim of this study is to assess the perception of pre-clinical students regarding doctors’ lifestyle. This study is a cross-sectional study involving all third-year pre-clinical medical students at University Sains Islam Malaysia. A total of 81 students participated in this study. Participants were given a set of questionnaire consisting of demographic data, open-ended questions on their perception on doctors’ lifestyle of working environment, salary expectation and family life. Thematic analysis were used to analyse the data. The participants comprised 69% female and their age range was between 20-21 years old. Majority of them were from middle-income families. Majority of the students perceived that the doctors’ lifestyle would be busy (72%). Approximately 30% of them expected that the time schedule will be unpredictable, 21% mentioned that sacrifice is required and 16% perceived it as a tiring job. Other themes emerged were ‘requiring high commitment’ (6%), challenging (7%) and risky (4%). With regards to salary expectation, 48% expected reasonable salary, 33% high salary and 12% described it as 'not worth compared to the workload'. Majority of them perceived that their family life will be restricted (62%) and time management is important (33%). Only 15% mentioned that family members have to sacrifice and spousal understanding is important (7%). About 10% of them perceived that their family will not be affected by their profession. Majority of the medical students perceived a busy doctors’ lifestyle, reasonable salary and restricted family life. However, there was a significant proportion of them who required counselling for better preparation of their future lifestyle.

Keywords: doctors lifestyle, pre-clinical students, perception, understanding

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Authors: Gaurav Vaidya, N. R. Mandal

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UN Summit, 2000 had resolved to provide access to sanitation to whole humanity as part of ‘Millennium Development Goals -2015’. However, more than one third of world’s population still did not have the access to basic sanitation facilities by 2015. Therefore, it will be a gigantic challenge to achieve goal-6 of ‘UN Sustainable Development Goal’ to ensure availability and sustainable management of sanitation for all by the year 2030. Countries attempt to find out own ways of meeting this challenge of providing access to safe sanitation and as part of monitoring the actions have prepared varied types of ‘performance assessment frameworks (PAF)’. India introduced Service Level Benchmarking (SLB) in 2010 to set targets and achieve the goals of NUSP. Further, a method of reviewing performance was introduced as ‘Swachh Sarvekshan’ (Cleanliness Surveys) in 2016 and in 2017 guidelines for the same was revised. This study, as a first step, reviews the documents in use in India with a conclusion that the frameworks adopted are based on target setting, financial allocation and performance in achieving the targets set. However, it does not focus upon sanitation needs holistically i.e., areas and aspects not targeted through projects are not covered in the performance assessment. In this context, as a second step, this study reviews literature available on performance assessment frameworks for urban sanitation in selected other countries and compares the same with that in India. The outcome of the comparative review resulted in identification of unaddressed aspects as well as inadequacy of parameters in Indian context. Thirdly, in an attempt to restructure the performance assessment process and develop an index in urban sanitation, researches done in other urban services such as health and education were studied focusing on methods of measuring under-performance. As a fourth step, a tentative modified framework is suggested with the help of understanding drawn from above for urban sanitation using stages of Urban Sanitation Service Chain Management (SSCM) and modified set of parameters drawn from the literature review in the first and second steps. This paper reviews existing literature on SSCM procedures, Performance Index in sanitation and other urban services and identifies a tentative list of parameters and a framework for measuring under-performance in sanitation services. This may aid in preparation of a Service Delivery Under-performance Index (SDUI) in future.

Keywords: assessment, performance, sanitation, services

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Authors: Wan-Ting Liao, Angela K. Tzeng

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Empathy has been an important issue in psychology, education, as well as cognitive neuroscience. Empathy has two major components: cognitive and emotional. Cognitive component refers to the ability to understand others’ perspectives, thoughts, and actions, whereas emotional component refers to understand how others feel. Empathy can be induced, attitude can then be changed, and with enough attitude change, helping behavior can occur. This finding leads us to two questions: is attitude change really necessary for prosocial behavior? And, what roles cognitive and affective empathy play? For the second question, participants with different psychopathic personality (PP) traits are critical because high PP people were found to suffer only affective empathy deficit. Their cognitive empathy shows no significant difference from the control group. 132 college students voluntarily participated in the current three-stage study. Stage 1 was to collect basic information including Interpersonal Reactivity Index (IRI), Psychopathic Personality Inventory-Revised (PPI-R), Attitude Scale, Visual Analogue Scale (VAS), and demographic data. Stage two was for empathy induction with three controversial scenarios, namely domestic violence, depression with a suicide attempt, and an ex-offender. Participants read all three stories and then rewrite the stories by one of two perspectives (empathetic vs. objective). They would then complete the VAS and Attitude Scale one more time for their post-attitude and emotional status. Three IVs were introduced for data analysis: PP (High vs. Low), Responsibility (whether or not the character is responsible for what happened), and Perspective-taking (Empathic vs. Objective). Stage 3 was for the action. Participants were instructed to freely use the 17 tokens they received as donations. They were debriefed and interviewed at the end of the experiment. The major findings were people with higher empathy tend to take more action in helping. Attitude change is not necessary for prosocial behavior. The controversy of the scenarios and how familiar participants are towards target groups play very important roles. Finally, people with high PP tend to show more public prosocial behavior due to their affective empathy deficit. Pre-existing value and belief as well as recent dramatic social events seem to have a big impact and possibly reduce the effect of the independent variables (IV) in our paradigm.

Keywords: empathy, cognitive, emotional, psychopathy

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Authors: James Brown, Stella Kortekaas, Ian Finnie, George Zhang, Christine Devine, Neil Healy

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The use of GIS as an analysis tool for engineering decision making is now best practice in the offshore industry. GIS enables multidisciplinary data integration, analysis and visualisation which allows the presentation of large and intricate datasets in a simple map-interface accessible to all project stakeholders. Presenting integrated geoscience and geotechnical data in GIS enables decision makers to be well-informed. This paper is a successful case study of how GIS spatial analysis techniques were applied to help select the most favourable pipeline route. Routing a pipeline through any natural environment has numerous obstacles, whether they be topographical, geological, engineering or financial. Where the pipeline is subjected to external hydrostatic water pressure and is carrying pressurised hydrocarbons, the requirement to safely route the pipeline through hazardous terrain becomes absolutely paramount. This study illustrates how the application of modern, GIS-based pipeline routing techniques enabled the identification of a single most-favourable pipeline route crossing of a challenging seabed terrain. Conventional approaches to pipeline route determination focus on manual avoidance of primary constraints whilst endeavouring to minimise route length. Such an approach is qualitative, subjective and is liable to bias towards the discipline and expertise that is involved in the routing process. For very short routes traversing benign seabed topography in shallow water this approach may be sufficient, but for deepwater geohazardous sites, the need for an automated, multi-criteria, and quantitative approach is essential. This study combined multiple routing constraints using modern least-cost-routing algorithms deployed in GIS, hitherto unachievable with conventional approaches. The least-cost-routing procedure begins with the assignment of geocost across the study area. Geocost is defined as a numerical penalty score representing hazard posed by each routing constraint (e.g. slope angle, rugosity, vulnerability to debris flows) to the pipeline. All geocosted routing constraints are combined to generate a composite geocost map that is used to compute the least geocost route between two defined terminals. The analyses were applied to select the most favourable pipeline route for a potential gas development in deep water. The study area is geologically complex with a series of incised, potentially active, canyons carved into a steep escarpment, with evidence of extensive debris flows. A similar debris flow in the future could cause significant damage to a poorly-placed pipeline. Protruding inter-canyon spurs offer lower-gradient options for ascending an escarpment but the vulnerability of periodic failure of these spurs is not well understood. Close collaboration between geoscientists, pipeline engineers, geotechnical engineers and of course the gas export pipeline operator guided the analyses and assignment of geocosts. Shorter route length, less severe slope angles, and geohazard avoidance were the primary drivers in identifying the most favourable route.

Keywords: geocost, geohazard, pipeline route determination, pipeline route optimisation, spatial analysis

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Authors: Yu Yoshihara, Chika Tada, Moe Takada, Nyam-Osor Purevdorj, Khorolmaa Chimedtseren, Yutaka Nakai

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Water pollution from animal waste and its influence on grazing animals is a current concern regarding Mongolian grazing lands. We allocated 32 free-grazing lambs to four groups and provided each with water from a different source (upper stream, lower stream, well, and pond) for 49 days. We recorded the amount of water consumed by the lambs, as well as their body weight, behavior, white blood cell count, acute phase (haptoglobin) protein level, and fecal condition. We measured the chemical and biological qualities of the four types of water, and we detected enteropathogenic and enterohemorrhagic Escherichia coli in fecal samples by using a genetic approach. Pond water contained high levels of nitrogen and minerals, and well water contained high levels of bacteria. The odor concentration index decreased in order from pond water to upper stream, lower stream, and well. On day 15 of the experiment, the following parameters were the highest in lambs drinking water from the following sources: water intake (pond or lower stream), body weight gain (pond), WBC count (lower stream), haptoglobin concentration (well), and enteropathogenic E. coli infection rate (lower stream). Lambs that drank well water spent more time lying down and less time grazing than the others, and lambs that drank pond water spent more time standing and less time lying down. Lambs given upper or lower stream water exhibited more severe diarrhea on day 15 of the experiment than before the experiment. Mongolian sheep seemed to adapt to chemically contaminated water: their productivity benefited the most from pond water, likely owing to its rich mineral content. Lambs that drank lower stream water showed increases in enteropathogenic E. coli infection, clinical diarrhea, and WBC count. Lambs that drank well water, which was bacteriologically contaminated, had increased serum acute phase protein levels and poor physical condition; they were thus at increased risk of negative health and production effects.

Keywords: DNA, Escherichia coli, fecal sample, lower stream, well water

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Authors: Akulov M. A., Zaharov V. O., Jurishhev P. E., Tomskij A. A.

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Introduction: Spasticity is a severe consequence of stroke, leading to profound disability, decreased quality of life and decrease of rehabilitation efficacy [4]. Spasticity is often associated with pain syndrome, arising from joint damage of paretic limbs (postural arthropathy) or painful spasm of paretic limb muscles. It is generally accepted that injection of botulinum toxin into a cramped muscle leads to decrease of muscle tone and improves motion range in paretic limb, which is accompanied by pain alleviation. Study aim: To evaluate the change in pain syndrome intensity after incections of botulinum toxin A (Xeomin) in stroke patients with upper limb spasticity. Patients and methods. 21 patients aged 47-74 years were evaluated. Inclusion criteria were: acute stroke 4-7 months before the inclusion into the study, leading to spasticity of wrist and/or finger flexors, elbow flexor or forearm pronator, associated with severe pain syndrome. Patients received Xeomin as monotherapy 90-300 U, according to spasticity pattern. Efficacy evaluation was performed using Ashworth scale, disability assessment scale (DAS), caregiver burden scale and global treatment benefit assessment on weeks 2, 4, 8 and 12. Efficacy criterion was the decrease of pain syndrome by week 4 on PQLS and VAS. Results: The study revealed a significant improvement of measured indices after 4 weeks of treatment, which persisted until the 12 week of treatment. Xeomin is effective in reducing muscle tone of flexors of wrist, fingers and elbow, forearm pronators. By the 4th week of treatment we observed a significant improvement on DAS (р < 0,05), Ashworth scale (1-2 points) in all patients (р < 0,05), caregiver burden scale (р < 0,05). A significant decrease of pain syndrome by the 4th week of treatment on PQLS (р < 0,05) и VAS (р < 0,05) was observed. No adverse effect were registered. Conclusion: Xeomin is an effective treatment of pain syndrome in postural upper limb spasticity after stroke. Xeomin treatment leads to a significant improvement on PQLS and VAS.

Keywords: botulinum toxin, pain syndrome, spasticity, stroke

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Authors: Usman Bawa

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Macro-invertebrates have been used to monitor organic pollution in rivers and streams. Several biotic indices based on macro-invertebrates have been developed over the years including the Biological Monitoring Working Party (BMWP). A new biotic index, the Gammarus:Asellus ratio has been recently proposed as an index of organic pollution. This study tested the validity of the Gammarus:Asellus ratio as an index of organic pollution, by examining the relationship between the Gammarus:Asellus ratio and physical-chemical parameters, and other biotic indices such as BMWP and, Average Score Per Taxon (ASPT) from lakes and streams at Markeaton Park, Allestree Park, and Kedleston Hall, Derbyshire. Macro invertebrates were sampled using the standard five-minute kick sampling techniques physical and chemical environmental variables were obtained based on standard sampling techniques. Eighteen sites were sampled, six sites from Markeaton Park (three sites across the stream and three sites across the lake). Six sites each were also sampled from Allestree Park and Kedleston Hall lakes. The Gammarus:Asellus ratio showed an opposite significant positive correlations with parameters indicative of organic pollution such as the level of nitrates, phosphates, and calcium and also revealed a negatively significant correlations with other biotic indices (BMWP/ASPT). The BMWP score correlated positively significantly with some water quality parameters such as dissolved oxygen and flow rate, but revealed no correlations with other chemical environmental variables. The BMWP score was significantly higher in the stream than the lake in Markeaton Park, also The ASPT scores appear to be significantly higher in the upper Lakes than the middle and lower lakes. This study has further strengthened the use of BMWP/ASPT score as an index of organic pollution. But, additional application is required to validate the use of Gammarus:Asellus as a rapid bio monitoring tool.

Keywords: Asellus, biotic index, Gammarus, macro invertebrates, organic pollution

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Authors: Urrutia Fernando, López Jessica, Sánchez Carlos, San Antonio Thalía

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Ecuador, as a signatory country of the convention of the rights of persons with disabilities (CRPD) has, in the recent years, strengthened the structures and legal framework required to protect this minority comprised of 13.2% of its total population. However, the reality is that this group has disproportionately low earnings and low educational attainment in comparison with the general population. The main struggles, to promote job placement of wheelchairs users, are environmental discrimination caused by accessibility in structures and transportation, this mainly due to the cost, for private and public entities, of performing the reasonable accommodation they require. It is widely known that product development and production is needed to support effective implementation of the CRPD and that walking and standing are the major life activities, in this context the objective of this investigation is to promote job placement of wheelchair user in the province of Tungurahua by means of the design, production and marketing of a customized stand up wheelchair. Exploratory interviews and measurements were performed in a representative sample of working age wheelchairs users that develop their disability after achieving their physical maturity and that are capable of performing professional activities with their upper limbs, this in order to detect the user’s preference and determine the local economic and anthropometric parameters to be included in the wheelchair design. The findings reveal factors that uniquely impact quality of life and development for people with a mobility disability within the context of the province, first that transportation is a big issue since public buses does not have accessibility for wheelchair users and the absence of curb cuts and the presence of trash bins over the sidewalks among other hinders an economic independent mobility, second that the proposal based in the idea of modifying the wheelchairs to make it able to overcome certain obstacles helps people in wheelchair to improve their independent living and by reducing the costs of modification for the employer could improve their chances of finding work.

Keywords: anthropometrics, job placement, stand up wheelchair, user centered design

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Authors: Nomcebo N. Mpili, Cynthia Z. Madlabana

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The South African Primary Health Care (PHC) system has undergone a number of transformations such as the introduction of National Health Insurance (NHI) to bring about easily accessible universal health coverage and to meet the health needs for all its citizens. This provides ongoing challenges to ensure that health workers are equipped with appropriate knowledge, support, and skills to meet these changes. Therefore it is crucial to understand the experiences and challenges of nurses as the backbone of PHC in providing quality healthcare services. In addition there has been a need to understand nurses’ experiences with management support, role ambiguity and role conflict amongst other challenges in light of the current reforms in healthcare. Indeed these constructs are notorious for having a detrimental impact on the outcomes of change initiatives within any organisation, this is no different in healthcare. This draws a discussion on professional nurses within the South African health care system especially since they have been labelled as the backbone of PHC, meaning any healthcare backlog falls on them. The study made use of semi-structured interviews and adopted the interpretative phenomenological approach (IPA) as the researcher aimed to explore the lived experiences of (n= 18) participants. The study discovered that professional nurses experienced a lack of management support within PHC facilities and that management mainly played an administrative and disciplinary role. Although participants mainly held positive perceptions with regards to changes happening in health care however they also expressed negative experiences in terms of how change initiatives were introduced resulting in role conflict and role ambiguity. Participants mentioned a shortage of staff, inadequate training as well as a lack of management support as some of the key challenges faced in facilities. This study offers unique findings as participants have not only experienced the various reforms within the PHC system however they have also been part of NHI pilot. The authors are not aware of any other studies published that examine management support, role conflict and role ambiguity together especially in South African PHC facilities. In conclusion understanding these challenges may provide insight and opportunities available to improve the current landscape of PHC not only in South Africa but internationally.

Keywords: management support, professional nurse, role ambiguity, role conflict

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Authors: Filip Rusak, Yulia Arzhaeva, Dadong Wang

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Machine learning based Computer-Aided Diagnosis (CAD) is gaining much popularity in medical imaging and diagnostic radiology. However, it requires a large amount of high quality and labeled training image datasets. The training images may come from different sources and be acquired from different radiography machines produced by different manufacturers, digital or digitized copies of film radiographs, with various sizes as well as different pixel intensity distributions. In this paper, a content-aware image augmentation method is presented to deal with these variations. The results of the proposed method have been validated graphically by plotting the removed and added seams of pixels on original images. Two different chest X-ray (CXR) datasets are used in the experiments. The CXRs in the datasets defer in size, some are digital CXRs while the others are digitized from analog CXR films. With the proposed content-aware augmentation method, the Seam Carving algorithm is employed to resize CXRs and the corresponding labels in the form of image masks, followed by histogram matching used to normalize the pixel intensities of digital radiography, based on the pixel intensity values of digitized radiographs. We implemented the algorithms, resized the well-known Montgomery dataset, to the size of the most frequently used Japanese Society of Radiological Technology (JSRT) dataset and normalized our digital CXRs for testing. This work resulted in the unified off-the-shelf CXR dataset composed of radiographs included in both, Montgomery and JSRT datasets. The experimental results show that even though the amount of augmentation is large, our algorithm can preserve the important information in lung fields, local structures, and global visual effect adequately. The proposed method can be used to augment training and testing image data sets so that the trained machine learning model can be used to process CXRs from various sources, and it can be potentially used broadly in any medical imaging applications.

Keywords: computer-aided diagnosis, image augmentation, lung segmentation, medical imaging, seam carving

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Authors: Daphne Sobolev, Niklas Voege

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During the last three decades, consumer ethics perceptions have attracted the attention of a large number of researchers. Nevertheless, little is known about the effect of the cognitive and situational contexts of the decision on ethics judgments. In this paper, the interrelationship between consumers’ ethics perceptions, legality evaluations and mind-sets are explored. Legality evaluations represent the cognitive context of the ethical judgments, whereas mind-sets represent their situational context. Drawing on moral development theories and priming theories, it is hypothesized that both factors are significantly related to consumer ethics perceptions. To test this hypothesis, 289 participants were allocated to three mind-set experimental conditions and a control group. Participants in the mind-set conditions were primed for aggressiveness, politeness or awareness to the negative legal consequences of breaking the law. Mind-sets were induced using a sentence-unscrambling task, in which target words were included. Ethics and legality judgments were assessed using consumer ethics and internet ethics questionnaires. All participants were asked to rate the ethicality and legality of consumer actions described in the questionnaires. The results showed that consumer ethics and legality perceptions were significantly correlated. Moreover, including legality evaluations as a variable in ethics judgment models increased the predictive power of the models. In addition, inducing aggressiveness in participants reduced their sensitivity to ethical issues; priming awareness to negative legal consequences increased their sensitivity to ethics when uncertainty about the legality of the judged scenario was high. Furthermore, the correlation between ethics and legality judgments was significant overall mind-set conditions. However, the results revealed conflicts between ethics and legality perceptions: consumers considered 10%-14% of the presented behaviors unethical and legal, or ethical and illegal. In 10-23% of the questions, participants indicated that they did not know whether the described action was legal or not. In addition, an asymmetry between the effects of aggressiveness and politeness priming was found. The results show that the legality judgments and mind-sets interact with consumer ethics perceptions. Thus, they portray consumer ethical judgments as dynamical processes which are inseparable from other cognitive processes and situational variables. They highlight that legal and ethical education, as well as adequate situational cues at the service place, could have a positive effect on consumer ethics perceptions. Theoretical contribution is discussed.

Keywords: consumer ethics, legality judgments, mind-set, priming, aggressiveness

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Authors: Stefan Kurbatfinski, Aliyah Dosani, Andrew F. Hayes, Deborah Dewey, Nicole Letourneau

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Background: Maternal adverse childhood experiences (ACEs) have been associated with internalizing and externalizing behavioral problems in preschool children. However, little is known about the influence of maternal adult attachment patterns on this association. Further, potential moderation by maternal mental health, maternal social support, or child sex is poorly understood. Therefore, this study examined associations between 1) maternal ACEs and preschool children’s behavioural problems, with mediation through maternal attachment patterns and moderation by maternal mental health, maternal social support, and child sex; and 2) maternal attachment patterns and children’s behavioural problems, with mediation through maternal mental health and social support and moderation by child sex. Methods: This secondary analysis used data (n=625) from a high socioeconomic, longitudinally prospective cohort (Alberta Pregnancy Outcomes and Nutrition). Child behaviour (BASC-2) and maternal adult attachment (ECR-Q) were measured at five years of child age, maternal ACEs (ACEs Questionnaire) at around 12 months, and maternal mental health (CESD and SCL-90-R) and social support (SSQ) across various prenatal and postnatal time points. All moderation and mediation analyses occurred through RStudio using PROCESS, interpreting significant interactions through Johnson-Neyman plots. Findings: Maternal ACEs interacted with maternal anxiety symptoms to predict both behavioural problems (pexternalizing=0.007; pinternalizing=0.0159). An indirect pathway via dismissive attachment was moderated by maternal social support ([0.0058, 0.0596]). Attachment patterns predicted all behavioural problems (p<0.05) and interacted with maternal anxiety symptoms to predict internalizing behaviours among male children ([0.0321, 0.1307]; [0.0321, 0.1291]). Interpretation: Maternal attachment patterns may predict children’s behavioural problems more than ACEs. Social support interventions may not always be beneficial for highly dismissively attached mothers. Implications for policy and child health include mandatory sex and gender education for teachers; assessing attachment patterns prior to recommending social support as an intervention; and anxiety-focused interventions for mothers in higher socioeconomic populations.

Keywords: maternal adverse childhood experiences, internalizing behaviours, externalizing behaviours, mediators and moderators, attachment patterns, child health

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Authors: Hendri Purwadi, Christine McCloud

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Triage is a complex decision-making process that aims to categorize a victim’s level of acuity and the need for medical assistance. Two common triage systems have been widely used in Mass Casualty Incidents (MCIs) and disaster situation are START (Simple triage algorithm and rapid treatment) and SALT (sort, asses, lifesaving, intervention, and treatment/transport). There is currently controversy regarding the effectiveness of SALT over START triage system. This systematic review aims to investigate and compare the effectiveness between SALT and START triage system in disaster and MCIs setting. Literatures were searched via systematic search strategy from 2009 until 2019 in PubMed, Cochrane Library, CINAHL, Scopus, Science direct, Medlib, ProQuest. This review included simulated-based and medical record -based studies investigating the accuracy and applicability of SALT and START triage systems of adult and children population during MCIs and disaster. All type of studies were included. Joana Briggs institute critical appraisal tools were used to assess the quality of reviewed studies. As a result, 1450 articles identified in the search, 10 articles were included. Four themes were identified by review, they were accuracy, under-triage, over-triage and time to triage per individual victim. The START triage system has a wide range and inconsistent level of accuracy compared to SALT triage system (44% to 94. 2% of START compared to 70% to 83% of SALT). The under-triage error of START triage system ranged from 2.73% to 20%, slightly lower than SALT triage system (7.6 to 23.3%). The over-triage error of START triage system was slightly greater than SALT triage system (START ranged from 2% to 53% compared to 2% to 22% of SALT). The time for applying START triage system was faster than SALT triage system (START was 70-72.18 seconds compared to 78 second of SALT). Consequently; The START triage system has lower level of under-triage error and faster than SALT triage system in classifying victims of MCIs and disaster whereas SALT triage system is known slightly more accurate and lower level of over-triage. However, the magnitude of these differences is relatively small, and therefore the effect on the patient outcomes is not significance. Hence, regardless of the triage error, either START or SALT triage system is equally effective to triage victims of disaster and MCIs.

Keywords: disaster, effectiveness, mass casualty incidents, START triage system, SALT triage system

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Authors: Reena K., Mamatha H. G., Somshekarayya, P. Kumar

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Objectives: The annual proficiency testing of intermediate reference laboratories is conducted by the National Reference Laboratory (NRL) to assess the efficiency of the laboratories to correctly identify Mycobacterium tuberculosis and to determine its drug susceptibility pattern. The proficiency testing results from 2013 to 2017 were analyzed to determine laboratories that were consistent in reporting quality results and those that had difficulty in doing so. Methods: A panel of twenty cultures were sent out to each of these laboratories. The laboratories were expected to grow the cultures in their own laboratories, set up drug susceptibly testing by all the methods they were certified for and report the results within the stipulated time period. The turnaround time for reporting results, specificity, sensitivity positive and negative predictive values and efficiency of the laboratory in identifying the cultures were analyzed. Results: Most of the laboratories had reported their results within the stipulated time period. However, there was enormous delay in reporting results from few of the laboratories. This was mainly due to improper functioning of the biosafety level III laboratory. Only 40% of the laboratories had 100% efficiency in solid culture using Lowenstein Jensen medium. This was expected as a solid culture, and drug susceptibility testing is not used for diagnosing drug resistance. Rapid molecular methods such as Line probe assay and Genexpert are used to determine drug resistance. Automated liquid culture system such as the Mycobacterial growth indicator tube is used to determine prognosis of the patient while on treatment. It was observed that 90% of the laboratories had achieved 100% in the liquid culture method. Almost all laboratories had achieved 100% efficiency in the line probe assay method which is the method of choice for determining drug-resistant tuberculosis. Conclusion: Since the liquid culture and line probe assay technologies are routinely used for the detection of drug-resistant tuberculosis the laboratories exhibited higher level of efficiency as compared to solid culture and drug susceptibility testing which are rarely used. The infrastructure of the laboratory should be maintained properly so that samples can be processed safely and results could be declared on time.

Keywords: annual proficiency testing, drug susceptibility testing, intermediate reference laboratory, national reference laboratory

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Authors: Z. Wang, F. Pashaei Kamali, J. A. Posada Duque, P. Osseweijer

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Globally, the aviation sector is seeking for sustainable solutions to comply with the pressure to reduce greenhouse gas emissions. Jet fuels derived from biomass are generally perceived as a sustainable alternative compared with their fossil counterparts. However, the establishment of jet biofuels supply chains will have impacts on environment, economy, and society. While existing studies predominantly evaluated environmental impacts and techno-economic feasibility of jet biofuels, very few studies took the social / socioeconomic aspect into consideration. Therefore, this study aims to provide a focused evaluation of social sustainability for aviation biofuels with a supply chain perspective. Three potential jet biofuel supply chains based on different feedstocks, i.e. sugarcane, eucalyptus, and macauba were analyzed in the context of Brazil. The assessment of social sustainability is performed with a process-based approach combined with input-output analysis. Over the supply chains, a set of social sustainability issues including employment, working condition (occupational accident and wage level), labour right, education, equity, social development (GDP and trade balance) and food security were evaluated in a (semi)quantitative manner. The selection of these social issues is based on two criteria: (1) the issues are highly relevant and important to jet biofuel production; (2) methodologies are available for assessing these issues. The results show that the three jet biofuel supply chains lead to a differentiated level of social effects. The sugarcane-based supply chain creates the highest number of jobs whereas the biggest contributor of GDP turns out to be the macauba-based supply chain. In comparison, the eucalyptus-based supply chain stands out regarding working condition. It is also worth noting that biojet fuel supply chain with high level of social benefits could result in high level of social concerns (such as occupational accident, violation of labour right and trade imbalance). Further research is suggested to investigate the possible interactions between different social issues. In addition, the exploration of a wider range of social effects is needed to expand the comprehension of social sustainability for biofuel supply chains.

Keywords: biobased supply chain, jet biofuel, social assessment, social sustainability, socio-economic impacts

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Authors: Anamika Sahu

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The Himalayas, like many mountainous regions, is susceptible to multiple hazards. In recent times, the frequency of such disasters is continuously increasing due to extreme weather phenomena. These natural hazards are responsible for irreparable human and economic loss. The Indian Himalayas has repeatedly been ruptured by great earthquakes in the past and has the potential for a future large seismic event as it falls under the seismic gap. Damages caused by earthquakes are different in different localities. It is well known that, during earthquakes, damage to the structure is associated with the subsurface conditions and the quality of construction materials. So, for sustainable mountain development, prior estimation of site characterization will be valuable for designing and constructing the space area and for efficient mitigation of the seismic risk. Both geotechnical and geophysical investigation of the subsurface is required to describe the subsurface complexity. In mountainous regions, geophysical methods are gaining popularity as areas can be studied without disturbing the ground surface, and also these methods are time and cost-effective. The MASW method is used to calculate the Vs30. Vs30 is the average shear wave velocity for the top 30m of soil. Shear wave velocity is considered the best stiffness indicator, and the average of shear wave velocity up to 30 m is used in National Earthquake Hazards Reduction Program (NEHRP) provisions (BSSC,1994) and Uniform Building Code (UBC), 1997 classification. Parameters obtained through geotechnical investigation have been integrated with findings obtained through the subsurface geophysical survey. Joint interpretation has been used to establish inter-relationships among mineral constituents, various textural parameters, and unconfined compressive strength (UCS) with shear wave velocity. It is found that results obtained through the MASW method fitted well with the laboratory test. In both conditions, mineral constituents and textural parameters (grain size, grain shape, grain orientation, and degree of interlocking) control the petrophysical and mechanical properties of rocks and the behavior of shear wave velocity.

Keywords: MASW, mechanical, petrophysical, site characterization

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Authors: Hsueh-Hsing Lu, Thi-Cuc Le, Tung-Sheng Tsai, Chuen-Jinn Tsai

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This study designed and tested a novel wet electrostatic precipitators (WEP) system featuring a Pulse-Air-Jet-Assisted Water Flow (PJWF) to shorten water cleaning time, reduce water usage, and maintain high particle removal efficiency. The PJWF injected cleaning water tangentially at the cylinder wall, rapidly enhancing the momentum of the water flow for efficient dust cake removal. Each PJWF cycle uses approximately 4.8 liters of cleaning water in 18 seconds. Comprehensive laboratory tests were conducted using a single-tube WEP prototype within a flow rate range of 3.0 to 6.0 cubic meters per minute(CMM), operating voltages between -35 to -55 kV, and high-frequency power supply. The prototype, consisting of 72 sets of double-spike rigid discharge electrodes, demonstrated that with the PJWF, -35 kV, and 3.0 CMM, the PM2.5 collection efficiency remained as high as the initial value of 88.02±0.92% after loading with Al2O3 particles at 35.75± 2.54 mg/Nm3 for 20-hr continuous operation. In contrast, without the PJWF, the PM2.5 collection efficiency drastically dropped from 87.4% to 53.5%. Theoretical modeling closely matched experimental results, confirming the robustness of the system's design and its scalability for larger industrial applications. Future research will focus on optimizing the PJWF system, exploring its performance with various particulate matter, and ensuring long-term operational stability and reliability under diverse environmental conditions. Recently, this WEP was combined with a preceding CT (cooling tower) and a HWS (honeycomb wet scrubber) and pilot-tested (40 CMM) to remove SO2 and PM2.5 emissions in a sintering plant of an integrated steel making plant. Pilot-test results showed that the removal efficiencies for SO2 and PM2.5 emissions are as high as 99.7 and 99.3 %, respectively, with ultralow emitted concentrations of 0.3 ppm and 0.07 mg/m3, respectively, while the white smoke is also eliminated at the same time. These new technologies are being used in the industry and the application in different fields is expected to be expanded to reduce air pollutant emissions substantially for a better ambient air quality.

Keywords: wet electrostatic precipitator, pulse-air-jet-assisted water flow, particle removal efficiency, air pollution control

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Authors: Fabian Nde Fon

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Decolonisation is one of the hottest topics in most African Universities; this is because many researchers focus on research that does not speak to their immediate community. This research looked at postgraduate research projects that can take students to the community to apply the knowledge that they have learned as an attempt to transform their community. In regards to this, an honours project was designed to try and provide a cheaper and continuous source of protein (egg) using amber-link layers and to investigate the potential of the project to promote postgraduate student development and entrepreneurship. Two ban layer production systems were created: (1) Production system one on a Hill (PS-I) and (2) Production system two in a valley, closer to a dam (PS-II) at Nqutshini, Gingindlovu, KwaZulu-Natal Province. Forty point-of-lay (18 weeks old) amber links were bought at Inverness Rearers and divided into PS-I (20), and PS-II (20), and each of the production systems was further divided into two groups of ten (PS-I-1 and PS-II-1 (partially supplemented) and PS-I-2 and PS-II-2 (supplemented with layer mash)) by a random selection. Birds' weights were balanced in each group to avoid bias. The two groups in each production system were caged separately (1.5x1.5m² for ten birds) and in close proximity. Partially supplemented birds received 0.6 kg of layer mash (60g/per bird/day) and kitchen leftovers daily, and supplemented birds were fed 1.2 kg of layer mash (120g/per bird/day). Egg collection was daily after feeding in the morning while was given ad libitium. The eggs were assessed for internal and external quality after weighing before recording. Egg production from fully supplemented birds (PS-I-2 and PS-II-2) was generally higher (P<0.05) than those of PS-I-1 and PS-II-1. The difference in production was only 6% in the valley while on the Hill, it was only 3%. However, some of the birds in the valley showed signs of respiratory infections, which was not observed with those on the Hill. There are no differences in the internal and external qualities of eggs (york colour and egg shell) determined. This implies that both systems were sustainable. It was suggested members in the community living at the valley or Hill can use these hardy layers as a cheaper source of protein and preferable to the partially supplemented systems because it is relatively cheaper. The smallholder farmers are still pursuing the project long after the students graduate; hence the benefit of the project is reciprocal for both the university and the community (entrepreneurship).

Keywords: animal nutrition, ban layer, production, postgraduate curricula, entrepreneurship

Procedia PDF Downloads 106

Authors: Ransford Kwaku Afeadie

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Purpose – The health challenges that characterises most of the migrants’ urban slums raise a lot of concern for their well-being. Health-seeking behaviour becomes an important step towards maintaining a healthy life. The importance of contextual issues is necessary to help meet specific community health needs and programmes. Therefore, this study aims to bridge the knowledge gap by investigating health-seeking behaviour disparity among rural-urban labour migrant slum dwellers before and after migration to the urban slums of Madina in the Greater Accra Region, Ghana. Design/methodology/approach – The author used explanatory sequential approach of research investigation. Questionnaire and interview guides were used to collect data from the respondents; however, in the absence of an existing reliable sampling frame, the various communities were selected by the use of cluster sampling proportional to size. At the second stage, a simple random sampling was used to select the various household heads. A total of 241 questionnaires were retrieved from the respondents representing a response rate of 100%. The author used the purposive sampling technique to conduct eight in-depth interviews and six key informants’ interviews. Findings – The author found various discrepancies in many of the activities that could fulfill substantial health-seeking behaviour in the slum as compared to migrant’s places of origin. The reason for coming to the slum amidst many settlements needs and low education background are the factors that accounted for this. This study, therefore, contradicts the proposition held by the health belief model. It is, therefore, important to note that contextual issues are key, in this case, rural-urban migrant slums present a different dynamic that must be taken into account when designing health programmes for such settings. Originality/value – Many, if not all the, studies on health-seeking behaviour have focused on urban slums without taking into account urban migrants’ slums. Such a failure to take into account the variations of the health needs of migrants’ urban slum settings can eventually lead to a mismatch of health programmes meant to address their challenges. Therefore, this study brings to the fore such variations that must be taken into account when designing health programmes. The study also indicates that even with the same people, there were disparities in terms of health-seeking behaviour in the slum and at places of origin.

Keywords: health-seeking behaviour, rural–urban migration, urban slums, health belief model

Procedia PDF Downloads 185

Authors: Karin Schakib-Ekbatan, Annette Roser

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According to the Federal Government’s plans, the German building stock should be virtually climate neutral by 2050. Thus, the “EnEff.Gebäude.2050” funding initiative was launched, complementing the projects of the Energy Transition Construction research initiative. Beyond the construction and renovation of individual buildings, solutions must be found at the neighborhood level. The subject of the presented pilot project is a building ensemble from the Wilhelminian period in Munich, which is planned to be refurbished based on a socially compatible, energy-saving, innovative-technical modernization concept. The building ensemble, with about 200 apartments, is part of the building cooperative. To create an optimized network and possible synergies between researchers and projects of the funding initiative, a Scientific Accompanying Research was established for cross-project analyses of findings and results in order to identify further research needs and trends. Thus, the project is characterized by an interdisciplinary approach that combines constructional, technical, and socio-scientific expertise based on a participatory understanding of research by involving the tenants at an early stage. The research focus is on getting insights into the tenants’ comfort requirements, attitudes, and energy-related behaviour. Both qualitative and quantitative methods are applied based on the Technology-Acceptance-Model (TAM). The core of the refurbishment strategy is a wall heating system intended to replace conventional radiators. A wall heating provides comfortable and consistent radiant heat instead of convection heat, which often causes drafts and dust turbulence. Besides comfort and health, the advantage of wall heating systems is an energy-saving operation. All apartments would be supplied by a uniform basic temperature control system (around perceived room temperature of 18 °C resp. 64,4 °F), which could be adapted to individual preferences via individual heating options (e. g. infrared heating). The new heating system would affect the furnishing of the walls, in terms of not allowing the wall surface to be covered too much with cupboards or pictures. Measurements and simulations of the energy consumption of an installed wall heating system are currently being carried out in a show apartment in this neighborhood to investigate energy-related, economical aspects as well as thermal comfort. In March, interviews were conducted with a total of 12 people in 10 households. The interviews were analyzed by MAXQDA. The main issue of the interview was the fear of reduced self-efficacy within their own walls (not having sufficient individual control over the room temperature or being very limited in furnishing). Other issues concerned the impact that the construction works might have on their daily life, such as noise or dirt. Despite their basically positive attitude towards a climate-friendly refurbishment concept, tenants were very concerned about the further development of the project and they expressed a great need for information events. The results of the interviews will be used for project-internal discussions on technical and psychological aspects of the refurbishment strategy in order to design accompanying workshops with the tenants as well as to prepare a written survey involving all households of the neighbourhood.

Keywords: energy efficiency, interviews, participation, refurbishment, residential buildings

Procedia PDF Downloads 121

Authors: Manjusha R. Vagal, Shyam K. Shrivastava, Umesh Mahantshetty, Sudeep Gupta, Supriya Chopra, Reena Engineer, Amita Maheshwari, Atul Buduk

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Vaginal stenosis is a common side effect associated with pelvic radiotherapy in cervical cancer patients which contributes negatively to woman’s health and prevents adequate vaginal/cervical examination. Vaginal dilation with a dilator is routine practice and is internationally advocated as a prophylactic measure to preserve vaginal patency. This retrospective study was carried out with the aim to know the usefulness of vaginal dilation following pelvic radiation therapy in cervical cancer patients in India. Data from medical records of 183 cervical cancer patients, which met the study criteria, were collected related to the stage of the disease, treatment received, commencement period of dilation post radiation therapy, sexual status and side effects associated to dilation practice. Data related to vaginal dimensions as per the length of insertion of a small, medium and large dilator were collected on regular follow-ups until 36 months and/or more. Vaginal dimensions as measured with the length of medium dilator insertion were used for analysis of dilation therapy results using paired t-test. Patients who underwent vaginal dilation with dilator maintained vaginal patency, also the mean vaginal length significantly increased, from 8.02 cm ± 2.69 to 9.96 ± 2.89 cm with a p value <0.001. There was no significant difference found on vaginal patency with different intervals of initiation of dilation therapy. At the third year and more following dilation therapy, significant increase in vaginal length observed with a p value of 0.0001 in both sexually active and inactive patients. Compilation of vaginal dosage during brachytherapy was inadequate, and hence, the secondary objective of the study to determine the effect of radiotherapy on the outcome of rehabilitation intervention was not studied in detail. This retrospective study has found that dilation therapy with vaginal dilators post pelvic radiotherapy is effective in preventing vaginal stenosis and improving vaginal patency and cannot be substituted with vaginal intercourse. Sexual quality of life assessment in the Indian population needs much attention.

Keywords: dilator, sexually active, vaginal dilation, vaginal stenosis

Procedia PDF Downloads 199

Authors: Nuri Balta, Ali Eryilmaz

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High-quality teachers are the key to improve student learning. Without a professional development of the teachers, the improvement of student success is difficult and incomplete. This study offers an in-service training course model for professional development of teachers (PD) entitled "teachers teaching teachers" (TTT). The basic premise of the PD program, designed for this study, was primarily aimed to increase the subject matter knowledge of high school physics teachers. The TTT course (the three hour long workshops), organized for this study, lasted for seven weeks with seventeen teachers took part in the TTT program at different amounts. In this study, the effect of the TTT program on teachers’ knowledge improvement was searched through the modern physics unit (MPU). The participating teachers taught the unit to one of their grade ten classes earlier, and they taught another equivalent class two months later. They were observed in their classes both before and after TTT program. The teachers were divided into placebo and the treatment groups. The aim of Solomon four-group design is an attempt to eliminate the possible effect of pre-test. However, in this study the similar design was used to eliminate the effect of pre teaching. The placebo group teachers taught their both classes as regular and the treatment group teachers had TTT program between the two teachings. The class observation results showed that the TTT program increased teachers’ knowledge and skills in teaching MPU. Further, participating in the TTT program caused teachers to teach the MPU in accordance with the requirements of the curriculum. In order to see any change in participating teachers’ success, an achievement test was applied to them. A large effect size (dCohen=.93) was calculated for the effect of TTT program on treatment group teachers’ achievement. The results suggest that staff developers should consider including topics, attractive to teachers, in-service training programs (a) to help teachers’ practice teaching the new topics (b) to increase the participation rate. During the conduction of the TTT courses, it was observed that teachers could not end some discussions and explain some concepts. It is now clear that teachers need support, especially when discussing counterintuitive concepts such as modern physics concepts. For this reason it is recommended that content focused PD programs be conducted at the helm of a scholarly coach.

Keywords: high school physics, in-service training course, modern physics unit, teacher professional development

Procedia PDF Downloads 191

Authors: Christine Eickhoff, Alyssa Adams, Alaine Duncan

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The Washington, DC Veterans Affairs Medical Center (DC VAMC) offers complementary and integrative health (CIH) services such as acupuncture, yoga, meditation, and nutrition education through a coordinated outpatient clinic. The primary population utilizing CIH services are veterans with chronic pain. Acupuncture is one of the most popular of the CIH services available at the DC VAMC. As interest and availability grows, it is important to measure health outcomes associated with CIH service utilization. The purpose of this study was to investigate pain and mental health outcomes for veterans with chronic pain enrolled in individual acupuncture services in the DC VAMC. Veterans at the DC VAMC with self-identified chronic pain and no prior acupuncture experience were recruited for the study (n=70). Veterans were referred for services by a medical provider and completed baseline assessments at the program orientation prior to participating in any CIH services. Veterans received four individual, full-body acupuncture appointments within four weeks of study enrollment. After the first month, participants were scheduled for six appointments that occurred every two weeks and then eight more sessions that were scheduled one month apart. Follow-up assessments were administered at 2, 4, 6, 8, and 12 months. The findings reported will include completed time points at two and four months. Measures include a demographics survey, the Measure Yourself Medical Outcome Profile-2 (MYMOP-2), The Beck Depression Inventory (BDI-II), the Defense Veterans Pain Rating Scale (DVPRS), and the Pain Disability Questionnaire (PDQ). In this sample, 67% identified a pain condition as their primary health concern. Between baseline and two-month follow-up, there were significant improvements in participants’ primary health concern (MYMOP-2 p=0.010), general wellbeing (MYMOP-2 p=0.011), and a significant decrease in the use of medication (MYMOP-2 p<0.000). Between 2 and 4-month follow-up, pain disability (PDQ p=0.035), pain rating (DVPRS p=0.027), and depression (BDI-II p=0.003) significantly improved. Preliminary findings indicate that individual acupuncture therapy can be effective at improving health outcomes, well-being, and decreasing medication use in U.S. military veterans with chronic pain. Findings also suggest that individual acupuncture therapy can improve pain ratings, pain disability, and depression in veterans with chronic pain.

Keywords: acupuncture, chronic pain, depression, integrative health, medication use, military, pain, veterans, wellbeing

Procedia PDF Downloads 252

Authors: Calvince Okome Odeny

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There is a current action to increase radiotherapy services in Kenya. The National government of Kenya, in collaboration with the county governments, has embarked on building radiotherapy centers in all 47 regions of the country. As these new centers are established in Kenya, it has to be ensured that minimum radiation safety standards are in place prior to operation. For full implementation of this, it is imperative that more Research and training for regulators are done on radiation protection, and safety and national regulatory infrastructure is geared towards ensuring radiation protection and safety in all aspects of the use of external radiotherapy practices. The present work aims at reviewing the level of protection and safety for patients and staff during external beam radiotherapy using Linac in Kenya and provides relevant guidance to improve protection and safety. A retrospective evaluation was done to verify whether those occupationally exposed workers and patients are adequately protected from the harmful effect of radiation exposure during the treatment procedures using Linac. The project was experimental Research, also including an analysis of resource documents obtained from the literature and international organizations. The critical findings of the work revealed that the key elements of protection of occupationally exposed workers and patients include a comprehensive quality Management system governing all planned activities from siting, safety, and design of the Facility, construction, acceptance testing, commissioning, operation, and decommissioning of the Facility; Government empowering the Regulatory Authority to license Medical Linear facilities and to enforce the applicable regulations to ensure adequate protection; A comprehensive Radiation Protection and Safety program must be established to ensure adequate safety and protection of workers and patients during treatment planning and treatment delivery of patients and categories of staff associated with the Facility must be well educated and trained to perform professionally with a commitment to sound safety culture. Relevant recommendations from the findings are shared with the Medical Linear Accelerator facilities and the regulatory authority to provide guidance and continuous improvement of protection and safety to improve regulatory oversight.

Keywords: oncology, radiotherapy, protection, staff

Procedia PDF Downloads 71

Authors: Kamila Irena Szpunar

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The central idea of the study is considered from two perspectives. The first perspective includes the interpersonal relationships formed by coach and athlete. Another perspective is connected with motivational environment which is created by the coach in team. This study will show the interplay between the perceived motivational climate created by the coach and the interpersonal dynamics between coaches and athletes. It is important because it will supply knowledge of the interpersonal conditions that can foster adaptive or maladaptive behavior in sport conditions. It also ensures implications for understanding how the perceived motivational atmosphere in a team is manifested at the level of coach – athlete relationship and interactions. The primary purpose of the study was to identify the association between coach-athlete relationship and athletes' perception of the motivational climate in team sports. The secondary purposes examined the differences between female and male athletes in perceiving of the motivational climate and the coach athlete-relationship. To check coach-athlete relationship Polish translation of The Coach-Athlete Relationship Questionnaire will be used. It measures athletes' perceptions of coach- athlete relationship defined by 3+1 Cs conceptual model of the coach-athlete relationship. From this model were used three constructs such as closeness (feelings of trust, respect etc.), commitment (thoughts about the future of the relationship), and complementarity (co-operative interactions during practice sessions). To check perceived motivational climate will be used Polish translation of The Perceived Motivational Climate in Sport Questionnaire-2 (PMCSQ-2). PMCSQ-2 was created to assess athletes' perceptions of the motivational climates in their teams. The questionnaire includes two general dimensions, the perceived task-involving climate and the perceived ego-involving climate; each contains three subscales. To check the associations between elements the motivational climate and coach-athlete relationship was used canonical correlation analysis. Student's t-test was used to check gender differences in athletes' perceptions of the motivational climate and the coach-athlete relationship. The findings suggest that in Polish athletes' perceptions of the coach-athlete relationship have motivational significance and that there are gender differences between female and male athletes in both variables – coach-athlete relationship and kind of motivational climate. According to the author's knowledge, such kind of study has not been conducted in Polish conditions before and is the first study on the subject of the motivational climate and the coach-athlete relationship in Poland. Information from this study can be useful for the development of interventions for enhancing the quality of coach- athlete relationship and its associated outcomes connected with motivational climate.

Keywords: coach-athlete relationship, ego-involving climate, motivational climate, task-involving climate

Procedia PDF Downloads 195

Authors: Chiara Della Rocca, Gavino Piras, Andrea Berti, Alessandro Mameli

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DNA identification of human skeletal remains plays a valuable role in the forensic field, especially in missing persons and mass disaster investigations. Hard tissues, such as bones and teeth, represent a very common kind of samples analyzed in forensic laboratories because they are often the only biological materials remaining. However, the major limitation of using these compact samples relies on the extremely time–consuming and labor–intensive treatment of grinding them into powder before proceeding with the conventional DNA purification and extraction step. In this context, a DNA extraction assay called the TBone Ex kit (DNA Chip Research Inc.) was developed to digest bone chips without powdering. Here, we simultaneously analyzed bone and tooth samples that arrived at our police laboratory and belonged to 15 different forensic casework that occurred in Sardinia (Italy). A total of 27 samples were recovered from different scenarios and were exposed to extreme environmental factors, including sunlight, seawater, soil, fauna, vegetation, and high temperature and humidity. The TBone Ex kit was used prior to the EZ2 DNA extraction kit on the EZ2 Connect Fx instrument (Qiagen), and high-quality autosomal and Y-chromosome STRs profiles were obtained for the 80% of the caseworks in an extremely short time frame. This study provides additional support for the use of the TBone Ex kit for digesting bone fragments/whole teeth as an effective alternative to pulverization protocols. We empirically demonstrated the effectiveness of the kit in processing multiple bone samples simultaneously, largely simplifying the DNA extraction procedure and the good yield of recovered DNA for downstream genetic typing in highly compromised forensic real specimens. In conclusion, this study turns out to be extremely useful for forensic laboratories, to which the various actors of the criminal justice system – such as potential jury members, judges, defense attorneys, and prosecutors – required immediate feedback.

Keywords: DNA, skeletal remains, bones, tbone ex kit, extreme conditions

Procedia PDF Downloads 36

Authors: Behcet Al, Mustafa Bogan, Mehmet Murat Oktay, Suat Zengin, Hasan Bayram

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Objective: In the last two decades there is a strong scientific interest regarding the role of aerosols for the Earth’s climate and associated changes. Aerosol particles are very important to the Earth-atmosphere climate system playing a crucial role in cloud and precipitation processes, air quality and climate. Here, we evaluated the association between saharran dust and emergency department admission, hospitalization, and mortality. Method: The records of admission to emergency department of Gaziantep University and the dust stroms of 31 months were studied. Patients admitted to ED at dust strom with chronic obstructive lung disease (COLD), asthma bronchiale (AB), serebrovascular events (SVE), acute myocardial infarction (AMI), stabile and unstabile angina pectoris (SAAP andUSAP); and the days with and without dust stroms were included. The study was realized from March 2010 to October 2012. The admission of three days before strom (group 1), during strom days (group 2) and three days after strom (group 3) were determined. The mean level of dust PM10 particulate was calculated, and the results were compared. Results: 5864 patients with chronic obstructive lung disease, asthma bronchiale, serebrovascular events, acute myocardial infarction, stabile and unstabile angyina pectoris admitted during the days with and without dust stroms. 28 dust stroms ocurred during 31 months. The totaliy of stroms continiued 78 days. Of admissions, 35.5% (n=2075) were in group1, 29.8% (n=1746) in group 2, and 34.8% (n=2043) were in group 3. The mean of PM10 for groups (group 1, 2 and 3) were 78.53 mg/m3 (range 19–276) particulate, 108.7 mg/m3 (range 34–631) particulate, and 60.9 mg/m3 (range 17–160) particulate respectively. The mean admission per a day for groups were 24.86, 22.55, and 24.50 respectively. The mortality was 12 in group 1, 12 in group 2, and 17 in grou 3. The hospitalization ratio for groups were 0.24, 0.27, and 0.27 respectively. Conclusion: However, the mean level of PM10 particulate for groups 2 (in dust strom days) is significantly higher (p=0.001) than the days before (group 1) and after (group 3) dust stroms, the mean admissions/day, hostilalization and mortality related to deseases (COLD, AB, SVE, AMI, SAAP andUSA) for group 2 is lower than the group 1 and group 3.

Keywords: Saharran dust, PM10 particulate, emergency department admission, mortality

Procedia PDF Downloads 393

Authors: Mohammad Rahim Rahnama, Amir Ali Kharazmi, Safiye Rokni

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The tourism industry will be the most important unlimited, sustainable source of income after the oil and automotive industries by 2020 and not only countries, but cities are striving to apprehend its various facets. In line with this objective, the present descriptive-analytical study, through survey and using a questionnaire, seeks to evaluate the probability of tourists’ return and their recommendation to their countrymen to travel to Mashhad, Iran. The population under study is a sample of 384 foreign tourists who, in 2016, arrived at Mashhad, the second metropolis in Iran and its biggest religious city. The Kaplan-Meier estimator was used to analyze the data. Twenty-six percent of the tourists are female and 74% are male. On average, each tourist has had 3.02 trips abroad and 2.1 trips to Mashhad. Tourists from 14 different countries have arrived at Mashhad. Kuwait (15.9%), Armenia (15.6%), and Iraq (10.9%) were the countries where most tourists originated. Seventy-six percent of the tourists traveled with family and 90% of the tourists arrived at Mashhad via airplane. Major purposes of tourists’ trip include pilgrimage (27.9%), treatment (22.1%) followed by pilgrimage and treatment combined (35.4%). Major issues for tourists, in the order of priority, include quality of goods and services (30.2%), shopping (18%), and inhabitants’ treatment of foreigners (15.9%). Main tourist attractions, in addition to the Holy Shrine of Imam Reza, include Torqabeh and Shandiz (Torqabeh 40.9% and Shandiz 29.9%), Neyshabour (18.2%) followed by Kalat, 4.4%. The average willingness to return among tourists is 3.13, which is higher than the mean 3, indicating satisfaction with the stay in Mashhad. Similarly, the average for tourists’ recommending to their countrymen to visit Mashhad is 3.42, which is also an indicator of tourists’ satisfaction with their presence in Mashhad. According to the findings of the Kaplan-Meier estimator, an increase in the number of tourists’ trips to Mashhad, and an increase in the number of tourists’ foreign trips, reduces the probability of recommending a trip to Mashhad by tourists. Similarly, willingness to return is higher among those who stayed at a relatives’ home compared with other patterns of residence (hotels, self-catering accommodation, and pilgrim houses). Therefore, addressing the issues raised by tourists is essential for their return and their recommendation to others to travel to Mashhad.

Keywords: international tourist, probability of return, satisfaction, Mashhad

Procedia PDF Downloads 163

Authors: Bryana Woodard, Monica Mitchell, Kasey Harry, Ebony Washington, Megan Harris, Marcia Boyd, Regina Lynch, Daphene Baines, Surbi Bankar

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Introduction: African Americans experience mental health illnesses (i.e., depression, anxiety, etc.) at higher rates than their white counterparts. Despite this, they utilize mental health resources less and have lower mental health literacy, perhaps due to cultural barriers- including but not limited to mistrust. Research acknowledges African Americans’ close ties to community networks, identifying these linkages as key to establishing comfort and trust. Similarly, the church has historically been a space that creates unity and community among African Americans. Studies show that longstanding academic-community partnerships with organizations, such as churches and faith-based entities, have the capability to effectively address health and mental health barriers and needs in African Americans. The importance of implementing faith-based approaches is supported in the literature, however few empirical studies exist. This project describes the First Ladies for Health and Cincinnati Children's Hospital Medical Center (CCHMC) Partnership (FLFH-CCHMC Partnership) and the implementation and assessment of an annual Mental Health Symposium, the overall aim of which was to increase mental health awareness and decrease stigma in African American communities. Methods: The specific goals of the FLFH Mental Health Symposium were to (1) Collaborate with trusted partners to build trust with community participants; (2) Increase mental health literacy and decrease mental health stigma; (3) Understand the barriers to improving mental health and improving trust; (4) Assess the short-term outcomes two months following the symposium. Data were collected through post-event and follow-up surveys using a mixed methods approach. Results: More than 100 participants attended each year with over 350 total participants over three years. 98.7% of participants were African American, 86.67% female, 11.6% male, and 11.6% LGBTQ+/non-binary; 10.5% of participants were teens, with the remainder aged 20 to 80 plus. The event was successful in achieving its goals: (1a) Eleven different speakers from 8 community and church organizations presented; (1b) 93% of participants rated the overall symposium as very good or excellent (2a) Mental health literacy significantly increased each year with over 90% of participants reporting improvement in their “understanding” and “awareness of mental health (2b) Participants 'personal stigma surrounding mental health illness decreased each year with 92.3% of participants reporting changes in their “willingness to talk about and share” mental health challenges; (3) Barriers to mental health care were identified and included social stigma, lack of trust, and the cost of care. Data were used to develop priorities and an action plan for the FLFH-CCHMC Mental Health Partnership; (4) Follow-up data showed that participants sustained benefits of the FLFH Symposium and took actionable steps (e.g., meditation, referrals, etc.). Additional quantitative and qualitative data will be shared. Conclusions: Lower rates of mental health literacy and higher rates of stigma among participants in this initiative demonstrate the importance of mental health providers building trust and partnerships in communities. Working with faith-based entities provides an opportunity to mitigate and address mental health equity in African American communities.

Keywords: community psychology, faith-based, african-american, culturally competent care, mental health equity

Procedia PDF Downloads 27

Authors: F. Heyecan Giritli, Gizem Akgül

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Because of the raising population of world; the need for houses, buildings and infrastructures are increasing rapidly. Energy and water consumption, waste production continues to increase. If this situation of resources continues, there will be a significant loss for next generations. Therefore, there are a lot of researches and solutions developed in the world. Also sustainability criteria are collected together by some countries to serve construction industry with certification systems. Sustainable building production process’s scope requires different path from traditional building production process. Moreover, the key objective of sustainable buildings is that the process includes whole life cycle duration. The process approaches from the decision of the project to the end of it; so the project team is needed from the beginning of the integrated project delivery model. Further more, by defining project team at the beginning of the project provides communication among the team members and defined problem solving and decision making methods. In this research includes the certification systems among the world to comprehend the head lines and assessment criteria. Therefore, it is understand that usually all green building criteria have the same contents. The aim of this research is to assess the sustainable project stakeholder’ perceptions in Turkish construction industry from the point of occupation, job title and years of experience. Therefore, a survey is made to assess the perceptions of each attendant. In Turkey, sustainability criteria are not clearly defined; on the other hand some regulations like waste management, energy efficiency are made by legal agencies. LEED certification system is the most popular system in Turkey that has attended and certificated. From the LEED official data, it’s understood that 308 project registered in Turkey. Therefore, LEED sustainability criteria are used in the survey. Head lines of LEED certification criteria; sustainable sites, water efficiency, energy and atmosphere, material and resources, indoor environmental quality, innovation and regional priority are indicated to assess the perceptions of survey participants. Moreover, only surveying of criteria are not enough; so the equipment, methods, risks and benefits also considered.

Keywords: LEED, sustainability, perceptions, stakeholders, construction, Turkey, risk, benefit

Procedia PDF Downloads 298