Search results for: fuzzy delphi method
Commenced in January 2007
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Edition: International
Paper Count: 19378

Search results for: fuzzy delphi method

718 Comparative Study of Active Release Technique and Myofascial Release Technique in Patients with Upper Trapezius Spasm

Authors: Harihara Prakash Ramanathan, Daksha Mishra, Ankita Dhaduk

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Relevance: This qualitative study will educate the clinician in putting into practice the advanced method of movement science in restoring the function. Purpose: The purpose of this study is to compare the effectiveness of Active Release Technique and myofascial release technique on range of motion, neck function and pain in patients with upper trapezius spasm. Methods/Analysis: The study was approved by the institutional Human Research and Ethics committee. This study included sixty patients of age group between 20 to 55 years with upper trapezius spasm. Patients were randomly divided into two groups receiving Active Release Technique (Group A) and Myofascial Release Technique (Group B). The patients were treated for 1 week and three outcome measures ROM, pain and functional level were measured using Goniometer, Visual analog scale(VAS), Neck disability Index Questionnaire(NDI) respectively. Paired Sample 't' test was used to compare the differences of pre and post intervention values of Cervical Range of motion, Neck disability Index, Visual analog scale of Group A and Group B. Independent't' test was used to compare the differences between two groups in terms of improvement in cervical range of motion, decrease in visual analogue scale(VAS), decrease in Neck disability index score. Results: Both the groups showed statistically significant improvements in cervical ROM, reduction in pain and in NDI scores. However, mean change in Cervical flexion, cervical extension, right side flexion, left side flexion, right side rotation, left side rotation, pain, neck disability level showed statistically significant improvement (P < 0. 05)) in the patients who received Active Release Technique as compared to Myofascial release technique. Discussion and conclusions: In present study, the average improvement immediately post intervention is significantly greater as compared to before treatment but there is even more improvement after seven sessions as compared to single session. Hence, this proves that several sessions of Manual techniques are necessary to produce clinically relevant results. Active release technique help to reduce the pain threshold by removing adhesion and promote normal tissue extensibility. The act of tensioning and compressing the affected tissue both with digital contact and through the active movement performed by the patient can be a plausible mechanism for tissue healing in this study. This study concluded that both Active Release Technique (ART) and Myofascial release technique (MFR) are equally effective in managing upper trapezius muscle spasm, but more improvement can be achieved by Active Release Technique (ART). Impact and Implications: Active Release Technique can be adopted as mainstay of treatment approach in treating trapezius spasm for faster relief and improving the functional status.

Keywords: trapezius spasm, myofascial release, active release technique, pain

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717 Insights on the Halal Status of Antineoplastic and Immunomodulating Agents and Nutritional and Dietary Supplements in Malaysia

Authors: Suraiya Abdul Rahman, Perasna M. Varma, Amrahi Buang, Zhari Ismail, Wan Rosalina W. Rosli, Ahmad Rashidi M. Tahir

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Background: Muslims has the obligation to ensure that everything they consume including medicines should be halal. With the growing demands for halal medicines in October 2012, Malaysia has launched the world's first Halal pharmaceutical standards called Malaysian Standard MS 2424:2012 Halal Pharmaceuticals-General Guidelines to serve as a basic requirement for halal pharmaceuticals in Malaysia. However, the biggest challenge faced by pharmaceutical companies to comply is finding the origin or source of the ingredients and determine their halal status. Aim: This study aims to determine the halal status of the antineoplastic and immunomodulating agents, and nutritional and dietary supplements by analysing the origin of their active pharmaceutical ingredients (API) and excipients to provide an insight on the common source and halal status of pharmaceutical ingredients and an indication on adjustment required in order to be halal compliance. Method: The ingredients of each product available in a government hospital in central of Malaysia and their sources were determined from the product package leaflets, information obtained from manufacturer, reliable websites and standard pharmaceutical references. The ingredients were categorised as halal, musbooh or haram based on the definition set in MS2424. Results: There were 162 medications included in the study where 123 (76%) were under the antineoplastic and immunomodulating agents group, while 39 (24%) were nutritional and dietary supplements. In terms of the medication halal status, the proportion of halal, musbooh and haram were 40.1% (n=65), 58.6% (n=95) and 1.2% (n=2) respectively. With regards to the API, there were 89 (52%) different active ingredient identified for antineoplastic and immunomodulating agents with the proportion of 89.9% (n=80) halal and 10.1% (n=9) were mushbooh. There were 83 (48%) active ingredient from the nutritional and dietary supplements group with proportion of halal and masbooh were 89.2% (n=74) and 10.8% (n=9) respectively. No haram APIs were identified in all therapeutic classes. There were a total of 176 excipients identified from the products ranges. It was found that majority of excipients are halal with the proportion of halal, masbooh and haram were at 82.4% (n=145), 17% (n=30) and 0.6% (n=1) respectively. With regards of the sources of the excipeints, most of masbooh excipients (76.7%, n = 23) were classified as masbooh because they have multiple possible origin which consist of animals, plant or others. The remaining 13.3% and 10% were classified as masbooh due to their ethanol and land animal origin respectively. The one haram excipient was gelatine of bovine-porcine origin. Masbooh ingredients found in this research were glycerol, tallow, lactose, polysorbate, dibasic sodium phosphate, stearic acid and magnesium stearate. Ethanol, gelatine, glycerol and magnesium stearate were the most common ingredients classified as mushbooh. Conclusion: This study shows that most API and excipients are halal. However the majority of the medicines in these products categories are mushbooh due to certain excipients only, which could be replaced with halal alternative excipients. This insight should encourage the pharmaceutical products manufacturers to go for halal certification to meet the increasing demand for Halal certified medications for the benefit of mankind.

Keywords: antineoplastic and immunomodulation agents, halal pharmaceutical, MS2424, nutritional and dietary supplements

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716 Data Calibration of the Actual versus the Theoretical Micro Electro Mechanical Systems (MEMS) Based Accelerometer Reading through Remote Monitoring of Padre Jacinto Zamora Flyover

Authors: John Mark Payawal, Francis Aldrine Uy, John Paul Carreon

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This paper shows the application of Structural Health Monitoring, SHM into bridges. Bridges are structures built to provide passage over a physical obstruction such as rivers, chasms or roads. The Philippines has a total of 8,166 national bridges as published on the 2015 atlas of the Department of Public Works and Highways (DPWH) and only 2,924 or 35.81% of these bridges are in good condition. As a result, PHP 30.464 billion of the 2016 budget of DPWH is allocated on roads and/or bridges maintenance alone. Intensive spending is owed to the present practice of outdated manual inspection and assessment, and poor structural health monitoring of Philippine infrastructures. As the School of Civil, Environmental, & Geological Engineering of Mapua Institute of Technology (MIT) continuous its well driven passion in research based projects, a partnership with the Department of Science and Technology (DOST) and the DPWH launched the application of Structural Health Monitoring, (SHM) in Padre Jacinto Zamora Flyover. The flyover is located along Nagtahan Boulevard in Sta. Mesa, Manila that connects Brgy. 411 and Brgy. 635. It gives service to vehicles going from Lacson Avenue to Mabini Bridge passing over Legarda Flyover. The flyover is chosen among the many located bridges in Metro Manila as the focus of the pilot testing due to its site accessibility, and complete structural built plans and specifications necessary for SHM as provided by the Bureau of Design, BOD department of DPWH. This paper focuses on providing a method to calibrate theoretical readings from STAAD Vi8 Pro and sync the data to actual MEMS accelerometer readings. It is observed that while the design standards used in constructing the flyover was reflected on the model, actual readings of MEMS accelerometer display a large difference compared to the theoretical data ran and taken from STAAD Vi8 Pro. In achieving a true seismic response of the modeled bridge or hence syncing the theoretical data to the actual sensor reading also called as the independent variable of this paper, analysis using single degree of freedom (SDOF) of the flyover under free vibration without damping using STAAD Vi8 Pro is done. The earthquake excitation and bridge responses are subjected to earthquake ground motion in the form of ground acceleration or Peak Ground Acceleration, PGA. Translational acceleration load is used to simulate the ground motion of the time history analysis acceleration record in STAAD Vi8 Pro.

Keywords: accelerometer, analysis using single degree of freedom, micro electro mechanical system, peak ground acceleration, structural health monitoring

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715 Management of Dysphagia after Supra Glottic Laryngectomy

Authors: Premalatha B. S., Shenoy A. M.

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Background: Rehabilitation of swallowing is as vital as speech in surgically treated head and neck cancer patients to maintain nutritional support, enhance wound healing and improve quality of life. Aspiration following supraglottic laryngectomy is very common, and rehabilitation of the same is crucial which requires involvement of speech therapist in close contact with head and neck surgeon. Objectives: To examine the functions of swallowing outcomes after intensive therapy in supraglottic laryngectomy. Materials: Thirty-nine supra glottic laryngectomees were participated in the study. Of them, 36 subjects were males and 3 were females, in the age range of 32-68 years. Eighteen subjects had undergone standard supra glottis laryngectomy (Group1) for supraglottic lesions where as 21 of them for extended supraglottic laryngectomy (Group 2) for base tongue and lateral pharyngeal wall lesion. Prior to surgery visit by speech pathologist was mandatory to assess the sutability for surgery and rehabilitation. Dysphagia rehabilitation started after decannulation of tracheostoma by focusing on orientation about anatomy, physiological variation before and after surgery, which was tailor made for each individual based on their type and extent of surgery. Supraglottic diet - Soft solid with supraglottic swallow method was advocated to prevent aspiration. The success of intervention was documented as number of sessions taken to swallow different food consistency and also percentage of subjects who achieved satisfactory swallow in terms of number of weeks in both the groups. Results: Statistical data was computed in two ways in both the groups 1) to calculate percentage (%) of subjects who swallowed satisfactorily in the time frame of less than 3 weeks to more than 6 weeks, 2) number of sessions taken to swallow without aspiration as far as food consistency was concerned. The study indicated that in group 1 subjects of standard supraglottic laryngectomy, 61% (n=11) of them were successfully rehabilitated but their swallowing normalcy was delayed by an average 29th post operative day (3-6 weeks). Thirty three percentages (33%) (n=6) of the subjects could swallow satisfactorily without aspiration even before 3 weeks and only 5 % (n=1) of the needed more than 6 weeks to achieve normal swallowing ability. Group 2 subjects of extended SGL only 47 %( n=10) of them could achieved satisfactory swallow by 3-6 weeks and 24% (n=5) of them of them achieved normal swallowing ability before 3 weeks. Around 4% (n=1) needed more than 6 weeks and as high as 24 % (n=5) of them continued to be supplemented with naso gastric feeding even after 8-10 months post operative as they exhibited severe aspiration. As far as type of food consistencies were concerned group 1 subject could able to swallow all types without aspiration much earlier than group 2 subjects. Group 1 needed only 8 swallowing therapy sessions for thickened soft solid and 15 sessions for liquids whereas group 2 required 14 sessions for soft solid and 17 sessions for liquids to achieve swallowing normalcy without aspiration. Conclusion: The study highlights the importance of dysphagia intervention in supraglottic laryngectomees by speech pathologist.

Keywords: dysphagia management, supraglotic diet, supraglottic laryngectomy, supraglottic swallow

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714 Comparative Investigation of Two Non-Contact Prototype Designs Based on a Squeeze-Film Levitation Approach

Authors: A. Almurshedi, M. Atherton, C. Mares, T. Stolarski, M. Miyatake

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Transportation and handling of delicate and lightweight objects is currently a significant issue in some industries. Two common contactless movement prototype designs, ultrasonic transducer design and vibrating plate design, are compared. Both designs are based on the method of squeeze-film levitation, and this study aims to identify the limitations, and challenges of each. The designs are evaluated in terms of levitation capabilities, and characteristics. To this end, theoretical and experimental explorations are made. It is demonstrated that the ultrasonic transducer prototype design is better suited to the terms of levitation capabilities. However, the design has some operating and mechanical designing difficulties. For making accurate industrial products in micro-fabrication and nanotechnology contexts, such as semiconductor silicon wafers, micro-components and integrated circuits, non-contact oil-free, ultra-precision and low wear transport along the production line is crucial for enabling. One of the designs (design A) is called the ultrasonic chuck, for which an ultrasonic transducer (Langevin, FBI 28452 HS) comprises the main part. Whereas the other (design B), is a vibrating plate design, which consists of a plain rectangular plate made of Aluminium firmly fastened at both ends. The size of the rectangular plate is 200x100x2 mm. In addition, four rounded piezoelectric actuators of size 28 mm diameter with 0.5 mm thickness are glued to the underside of the plate. The vibrating plate is clamped at both ends in the horizontal plane through a steel supporting structure. In addition, the dynamic of levitation using the designs (A and B) has been investigated based on the squeeze film levitation (SFL). The input apparatus that is used with designs consist of a sine wave signal generator connected to an amplifier type ENP-1-1U (Echo Electronics). The latter has to be utilised to magnify the sine wave voltage that is produced by the signal generator. The measurements of the maximum levitation for three different semiconductor wafers of weights 52, 70 and 88 [g] for design A are 240, 205 and 187 [um], respectively. Whereas the physical results show that the average separation distance for a disk of 5 [g] weight for design B reaches 70 [um]. By using the methodology of squeeze film levitation, it is possible to hold an object in a non-contact manner. The analyses of the investigation outcomes signify that the non-contact levitation of design A provides more improvement than design B. However, design A is more complicated than design B in terms of its manufacturing. In order to identify an adequate non-contact SFL design, a comparison between two common such designs has been adopted for the current investigation. Specifically, the study will involve making comparisons in terms of the following issues: floating component geometries and material type constraints; final created pressure distributions; dangerous interactions with the surrounding space; working environment constraints; and complication and compactness of the mechanical design. Considering all these matters is essential for proficiently distinguish the better SFL design.

Keywords: ANSYS, floating, piezoelectric, squeeze-film

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713 Contraception in Guatemala, Panajachel and the Surrounding Areas: Barriers Affecting Women’s Contraceptive Usage

Authors: Natasha Bhate

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Contraception is important in helping to reduce maternal and infant mortality rates by allowing women to control the number and spacing in-between their children. It also reduces the need for unsafe abortions. Women worldwide use contraception; however, the contraceptive prevalence rate is still relatively low in Central American countries like Guatemala. There is also an unmet need for contraception in Guatemala, which is more significant in rural, indigenous women due to barriers preventing contraceptive use. The study objective was to investigate and analyse the current barriers women face, in Guatemala, Panajachel and the surrounding areas, in using contraception, with a view of identifying ways to overcome these barriers. This included exploring the contraceptive barriers women believe exist and the influence of males in contraceptive decision making. The study took place at a charity in Panajachel, Guatemala, and had a cross-sectional, qualitative design to allow an in-depth understanding of information gathered. This particular study design was also chosen to help inform the charity with qualitative research analysis, in view of their intent to create a local reproductive health programme. A semi-structured interview design, including photo facilitation to improve cross-cultural communication, with interpreter assistance, was utilized. A pilot interview was initially conducted with small improvements required. Participants were recruited through purposive and convenience sampling. The study host at the charity acted as a gatekeeper; participants were identified through attendance of the charity’s women’s-initiative programme workshops. 20 participants were selected and agreed to study participation with two not attending; a total of 18 participants were interviewed in June 2017. Interviews were audio-recorded and data were stored on encrypted memory sticks. Framework analysis was used to analyse the data using NVivo11 software. The University of Leeds granted ethical approval for the research. Religion, language, the community, and fear of sickness were examples of existing contraceptive barrier themes recognized by many participants. The influence of men was also an important barrier identified, with themes of machismo and abuse preventing contraceptive use in some women. Women from more rural areas were believed to still face barriers which some participants did not encounter anymore, such as distance and affordability of contraceptives. Participants believed that informative workshops in various settings were an ideal method of overcoming existing contraceptive barriers and allowing women to be more empowered. The involvement of men in such workshops was also deemed important by participants to help reduce their negative influence in contraceptive usage. Overall, four recommendations following this study were made, including contraceptive educational courses, a gender equality campaign, couple-focused contraceptive workshops, and further qualitative research to gain a better insight into men’s opinions regarding women using contraception.

Keywords: barrier, contraception, machismo, religion

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712 Production of Functional Crackers Enriched with Olive (Olea europaea L.) Leaf Extract

Authors: Rosa Palmeri, Julieta I. Monteleone, Antonio C. Barbera, Carmelo Maucieri, Aldo Todaro, Virgilio Giannone, Giovanni Spagna

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In recent years, considerable interest has been shown in the functional properties of foods, and a relevant role has been played by phenolic compounds, able to scavenge free radicals. A more sustainable agriculture has to emerge to guarantee food supply over the next years. Wheat, corn, and rice are the most common cereals cultivated, but also other cereal species, such as barley can be appreciated for their peculiarities. Barley (Hordeum vulgare L.) is a C3 winter cereal that shows high resistance at drought and salt stresses. There are growing interests in barley as ingredient for the production of functional foods due to its high content of phenolic compounds and Beta-glucans. In this respect, the possibility of separating specific functional fractions from food industry by-products looks very promising. Olive leaves represent a quantitatively significant by-product of olive grove farming, and are an interesting source of phenolic compounds. In particular, oleuropein, which provide important nutritional benefits, is the main phenolic compound in olive leaves and ranges from 17% to 23% depending upon the cultivar and growing season period. Together with oleuropein and its derivatives (e.g. dimethyloleuropein, oleuropein diglucoside), olive leaves further contain tyrosol, hydroxytyrosol, and a series of secondary metabolities structurally related to them: verbascoside, ligstroside, hydroxytyrosol glucoside, tyrosol glucoside, oleuroside, oleoside-11-methyl ester, and nuzhenide. Several flavonoids, flavonoid glycosides, and phenolic acids have also described in olive leaves. The aim of this work was the production of functional food with higher content of polyphenols and the evaluation of their shelf life. Organic durum wheat and barley grains contain higher levels of phenolic compounds were used for the production of crackers. Olive leaf extract (OLE) was obtained from cv. ‘Biancolilla’ by aqueous extraction method. Two baked goods trials were performed with both organic durum wheat and barley flours, adding olive leaf extract. Control crackers, made as comparison, were produced with the same formulation replacing OLE with water. Total phenolic compound, moisture content, activity water, and textural properties at different time of storage were determined to evaluate the shelf-life of the products. Our the preliminary results showed that the enriched crackers showed higher phenolic content and antioxidant activity than control. Alternative uses of olive leaf extracts for crackers production could represent a good candidate for the addition of functional ingredients because bakery items are daily consumed, and have long shelf-life.

Keywords: barley, functional foods, olive leaf, polyphenols, shelf life

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711 Barriers for Sustainable Consumption of Antifouling Products in the Baltic Sea

Authors: Bianca Koroschetz, Emma Mäenpää

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The purpose of this paper is to study consumer practices and meanings of different antifouling methods in order to identify the main barriers for sustainable consumption of antifouling products in the Baltic Sea. The Baltic Sea is considered to be an important tourism area. More than 3.5 million leisure boaters use the sea for recreational boating. Most leisure boat owners use toxic antifouling paint to keep barnacles from attaching to the hull. Attached barnacles limit maneuverability and add drag which in turn increases fuel costs. Antifouling paint used to combat barnacles causes particular problems, as the use of these products continuously adds to the distribution of biocides in the coastal ecosystem and leads to the death of marine organisms. To keep the Baltic Sea as an attractive tourism area measures need to be undertaken to stop the pollution coming from toxic antifouling paints. The antifouling market contains a wide range of environment-friendly alternative products such as a brush wash for boats, hand scrubbing devices, hull covers and boat lifts. Unfortunately, not a lot of boat owners use these environment-friendly alternatives and instead prefer the use of the traditional toxic copper paints. We ask “Why is the unsustainable consumption of toxic paints still predominant when there is a big range of environment-friendly alternatives available? What are the barriers for sustainable consumption?” Environmental psychology has concentrated on developing models of human behavior, including the main factors that influence pro-environmental behavior. The main focus of these models was directed to the individual’s attitudes, principals, and beliefs. However, social practice theory emphasizes the importance to study practices, as they have a stronger explanatory power than attitude-behavior to explain unsustainable consumer behavior. Thus, the study focuses on describing the material, meaning and competence of antifouling practice in order to understand the social and cultural embeddedness of the practice. Phenomenological interviews were conducted with boat owners using antifouling products such as paints and alternative methods. This data collection was supplemented with participant observations in marinas. Preliminary results indicate that different factors such as costs, traditions, advertising, frequency of use, marinas and application of method impact on the consumption of antifouling products. The findings have shown that marinas have a big influence on the consumption of antifouling goods. Some marinas are very active in supporting the sustainable consumption of antifouling products as for example in Stockholm area several marinas subsidize costs for using environmental friendly alternatives or even forbid toxic paints. Furthermore the study has revealed that environmental friendly methods are very effective and do not have to be more expensive than painting with toxic paints. This study contributes to a broader understanding why the unsustainable consumption of toxic paints is still predominant when a big range of environment-friendly alternatives exist. Answers to this phenomenon will be gained by studying practices instead of attitudes offering a new perspective on environmental issues.

Keywords: antifouling paint, Baltic Sea, boat tourism, sustainable consumption

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710 3D CFD Model of Hydrodynamics in Lowland Dam Reservoir in Poland

Authors: Aleksandra Zieminska-Stolarska, Ireneusz Zbicinski

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Introduction: The objective of the present work was to develop and validate a 3D CFD numerical model for simulating flow through 17 kilometers long dam reservoir of a complex bathymetry. In contrast to flowing waters, dam reservoirs were not emphasized in the early years of water quality modeling, as this issue has never been the major focus of urban development. Starting in the 1970s, however, it was recognized that natural and man-made lakes are equal, if not more important than estuaries and rivers from a recreational standpoint. The Sulejow Reservoir (Central Poland) was selected as the study area as representative of many lowland dam reservoirs and due availability of a large database of the ecological, hydrological and morphological parameters of the lake. Method: 3D, 2-phase and 1-phase CFD models were analysed to determine hydrodynamics in the Sulejow Reservoir. Development of 3D, 2-phase CFD model of flow requires a construction of mesh with millions of elements and overcome serious convergence problems. As 1-phase CFD model of flow in relation to 2-phase CFD model excludes from the simulations the dynamics of waves only, which should not change significantly water flow pattern for the case of lowland, dam reservoirs. In 1-phase CFD model, the phases (water-air) are separated by a plate which allows calculations of one phase (water) flow only. As the wind affects velocity of flow, to take into account the effect of the wind on hydrodynamics in 1-phase CFD model, the plate must move with speed and direction equal to the speed and direction of the upper water layer. To determine the velocity at which the plate will move on the water surface and interacts with the underlying layers of water and apply this value in 1-phase CFD model, the 2D, 2-phase model was elaborated. Result: Model was verified on the basis of the extensive flow measurements (StreamPro ADCP, USA). Excellent agreement (an average error less than 10%) between computed and measured velocity profiles was found. As a result of work, the following main conclusions can be presented: •The results indicate that the flow field in the Sulejow Reservoir is transient in nature, with swirl flows in the lower part of the lake. Recirculating zones, with the size of even half kilometer, may increase water retention time in this region •The results of simulations confirm the pronounced effect of the wind on the development of the water circulation zones in the reservoir which might affect the accumulation of nutrients in the epilimnion layer and result e.g. in the algae bloom. Conclusion: The resulting model is accurate and the methodology develop in the frame of this work can be applied to all types of storage reservoir configurations, characteristics, and hydrodynamics conditions. Large recirculating zones in the lake which increase water retention time and might affect the accumulation of nutrients were detected. Accurate CFD model of hydrodynamics in large water body could help in the development of forecast of water quality, especially in terms of eutrophication and water management of the big water bodies.

Keywords: CFD, mathematical modelling, dam reservoirs, hydrodynamics

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709 Thinking Lean in ICU: A Time Motion Study Quantifying ICU Nurses’ Multitasking Time Allocation

Authors: Fatma Refaat Ahmed, Sally Mohamed Farghaly

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Context: Intensive care unit (ICU) nurses often face pressure and constraints in their work, leading to the rationing of care when demands exceed available time and resources. Observations suggest that ICU nurses are frequently distracted from their core nursing roles by non-core tasks. This study aims to provide evidence on ICU nurses' multitasking activities and explore the association between nurses' personal and clinical characteristics and their time allocation. Research Aim: The aim of this study is to quantify the time spent by ICU nurses on multitasking activities and investigate the relationship between their personal and clinical characteristics and time allocation. Methodology: A self-observation form utilizing the "Diary" recording method was used to record the number of tasks performed by ICU nurses and the time allocated to each task category. Nurses also reported on the distractions encountered during their nursing activities. A convenience sample of 60 ICU nurses participated in the study, with each nurse observed for one nursing shift (6 hours), amounting to a total of 360 hours. The study was conducted in two ICUs within a university teaching hospital in Alexandria, Egypt. Findings: The results showed that ICU nurses completed 2,730 direct patient-related tasks and 1,037 indirect tasks during the 360-hour observation period. Nurses spent an average of 33.65 minutes on ventilator care-related tasks, 14.88 minutes on tube care-related tasks, and 10.77 minutes on inpatient care-related tasks. Additionally, nurses spent an average of 17.70 minutes on indirect care tasks per hour. The study identified correlations between nursing time and nurses' personal and clinical characteristics. Theoretical Importance: This study contributes to the existing research on ICU nurses' multitasking activities and their relationship with personal and clinical characteristics. The findings shed light on the significant time spent by ICU nurses on direct care for mechanically ventilated patients and the distractions that require attention from ICU managers. Data Collection: Data were collected using self-observation forms completed by participating ICU nurses. The forms recorded the number of tasks performed, the time allocated to each task category, and any distractions encountered during nursing activities. Analysis Procedures: The collected data were analyzed to quantify the time spent on different tasks by ICU nurses. Correlations were also examined between nursing time and nurses' personal and clinical characteristics. Question Addressed: This study addressed the question of how ICU nurses allocate their time across multitasking activities and whether there is an association between nurses' personal and clinical characteristics and time allocation. Conclusion: The findings of this study emphasize the need for a lean evaluation of ICU nurses' activities to identify and address potential gaps in patient care and distractions. Implementing lean techniques can improve efficiency, safety, clinical outcomes, and satisfaction for both patients and nurses, ultimately enhancing the quality of care and organizational performance in the ICU setting.

Keywords: motion study, ICU nurse, lean, nursing time, multitasking activities

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708 Edge Enhancement Visual Methodology for Fat Amount and Distribution Assessment in Dry-Cured Ham Slices

Authors: Silvia Grassi, Stefano Schiavon, Ernestina Casiraghi, Cristina Alamprese

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Dry-cured ham is an uncooked meat product particularly appreciated for its peculiar sensory traits among which lipid component plays a key role in defining quality and, consequently, consumers’ acceptability. Usually, fat content and distribution are chemically determined by expensive, time-consuming, and destructive analyses. Moreover, different sensory techniques are applied to assess product conformity to desired standards. In this context, visual systems are getting a foothold in the meat market envisioning more reliable and time-saving assessment of food quality traits. The present work aims at developing a simple but systematic and objective visual methodology to assess the fat amount of dry-cured ham slices, in terms of total, intermuscular and intramuscular fractions. To the aim, 160 slices from 80 PDO dry-cured hams were evaluated by digital image analysis and Soxhlet extraction. RGB images were captured by a flatbed scanner, converted in grey-scale images, and segmented based on intensity histograms as well as on a multi-stage algorithm aimed at edge enhancement. The latter was performed applying the Canny algorithm, which consists of image noise reduction, calculation of the intensity gradient for each image, spurious response removal, actual thresholding on corrected images, and confirmation of strong edge boundaries. The approach allowed for the automatic calculation of total, intermuscular and intramuscular fat fractions as percentages of the total slice area. Linear regression models were run to estimate the relationships between the image analysis results and the chemical data, thus allowing for the prediction of the total, intermuscular and intramuscular fat content by the dry-cured ham images. The goodness of fit of the obtained models was confirmed in terms of coefficient of determination (R²), hypothesis testing and pattern of residuals. Good regression models have been found being 0.73, 0.82, and 0.73 the R2 values for the total fat, the sum of intermuscular and intramuscular fat and the intermuscular fraction, respectively. In conclusion, the edge enhancement visual procedure brought to a good fat segmentation making the simple visual approach for the quantification of the different fat fractions in dry-cured ham slices sufficiently simple, accurate and precise. The presented image analysis approach steers towards the development of instruments that can overcome destructive, tedious and time-consuming chemical determinations. As future perspectives, the results of the proposed image analysis methodology will be compared with those of sensory tests in order to develop a fast grading method of dry-cured hams based on fat distribution. Therefore, the system will be able not only to predict the actual fat content but it will also reflect the visual appearance of samples as perceived by consumers.

Keywords: dry-cured ham, edge detection algorithm, fat content, image analysis

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707 Trends in Conservation and Inheritance of Musical Culture of Ethnic Groups: A Case Study of the Akha Music in Chiang Rai Province, Thailand

Authors: Nutthan Inkhong, Sutthiphong Ruangchante

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Chiang Rai province is located at the northern border of Thailand. Most of the geography there is the northern continental highlands, and the population has many types of inhabitants, including Thai people, immigrants and ethnic groups such as Akha, Lahu, Lisu, Yao, etc. Most of these ethnic groups migrated from neighbouring countries such as Myanmar, Laos, China, etc. and settled in the mountains. Each ethnic group has their unique traditions, culture, and ways of life, including the musical culture that the ancestors of each ethnic group brought with them. In the present, the Akha have the largest population in the region and still live together in numerous villages in many districts. Thus, Akha musical culture still appears in the community traditions and cultural events of Chiang Rai province regularly. This article presents the situations of Akha musical culture in the present and the predictions for the future. The study method involves the analysis of music information and the related social contexts, which were collected from the fieldwork of ethnomusicological methodology by in-depth interviews, observations, audio and visual recordings, and related documents. The results found that the important persons who are related with Akha musical culture include (1) a musical instrument maker (lives in Mae Chan district) who produces various Akha musical instruments, including gourd mouth organs, Akha drums, two-way flutes, three-hole flutes, Jew’s harps (the sound of teenage love), buffalo horns (the sound symbol of hunting) and bird call instruments (the imitation of bird sounds), (2) a folk philosopher (lives in Mae Pha Luang district) who can teach music to the new generation of Akha people as well as lecture and demonstrate music to academics and tourists, and (3) a community leader (lives in Mae Chan district) who conserves Akha performances, singing and music through various activities of the students in an informal school. Because of the changes to the social contexts and ways of life of the Akha people, such as the educational system, religion, social media, etc., including the popularity of both Thai and international popular music among the new generation of Akha people, changes to and the fading away of Akha musical culture in the future may likely occur. Therefore, the conservation and inheritance of Akha music is an issue that should be resolved quickly. This primary study leads to the next step of the ethnomusicological work and plays a part in preventing or reducing the problems impacting Akha musical culture survival by the recording of Akha music in all of its dimensions, such as producing musical instruments, playing musical instruments, analysis of tuning systems, recording Akha music as musical notation using symbols, researching related social contexts, etc. and the transcription of this information to create lessons that can be returned to the Akha community.

Keywords: Akha music, Chiang Rai, ethnic music in Thailand, ethnomusicology

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706 Servant Leadership and Organisational Climate in South African Private Schools: A Qualitative Study

Authors: Christo Swart, Lidia Pottas, David Maree

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Background: It is a sine qua non that the South African educational system finds itself in a profound crisis and that traditional school leadership styles are outdated and hinder quality education. New thinking is mandatory to improve the status quo and school leadership has an immense role to play to improve the current situation. It is believed that the servant leadership paradigm, when practiced by school leadership, may have a significant influence on the school environment in totality. This study investigates the private school segment in search of constructive answers to assist with the educational crises in South Africa. It is assumed that where school leadership can augment a supportive and empowering environment for teachers to constructively engage in their teaching and learning activities - then many challenges facing by school system may be subjugated in a productive manner. Aim: The aim of this study is fourfold. To outline the constructs of servant leadership which are perceived by teachers of private schools as priorities to enhance a successful school environment. To describe the constructs of organizational climate which are observed by teachers of private schools as priorities to enhance a successful school environment. To investigate whether the participants perceived a link between the constructs of servant leadership and organizational climate. To consider the process to be followed to introduce the constructs of SL and OC the school system in general as perceived by participants. Method: This study utilized a qualitative approach to explore the mediation between school leadership and the organizational climate in private schools in the search for amicable answers. The participants were purposefully selected for the study. Focus group interviews were held with participants from primary and secondary schools and a focus group discussion was conducted with principals of both primary and secondary schools. The interview data were transcribed and analyzed and identical patterns of coded data were grouped together under emerging themes. Findings: It was found that the practice of servant leadership by school leadership indeed mediates a constructive and positive school climate. It was found that the constructs of empowerment, accountability, humility and courage – interlinking with one other - are prominent of servant leadership concepts that are perceived by teachers of private schools as priorities for school leadership to enhance a successful school environment. It was confirmed that the groupings of training and development, communication, trust and work environment are perceived by teachers of private schools as prominent features of organizational climate as practiced by school leadership to augment a successful school environment. It can be concluded that the participants perceived several links between the constructs of servant leadership and organizational climate that encourage a constructive school environment and that there is a definite positive consideration and motivation that the two concepts be introduced to the school system in general. It is recommended that school leadership mentors and guides teachers to take ownership of the constructs of servant leadership as well as organizational climate and that public schools be researched and consider to implement the two paradigms. The study suggests that aspirant teachers be exposed to leadership as well as organizational paradigms during their studies at university.

Keywords: empowering environment for teachers and learners, new thinking required, organizational climate, school leadership, servant leadership

Procedia PDF Downloads 222
705 Enhanced Physiological Response of Blood Pressure and Improved Performance in Successive Divided Attention Test Seen with Classical Instrumental Background Music Compared to Controls

Authors: Shantala Herlekar

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Introduction: Entrainment effect of music on cardiovascular parameters is well established. Music is being used in the background by medical students while studying. However, does it really help them relax faster and concentrate better? Objectives: This study was done to compare the effects of classical instrumental background music versus no music on blood pressure response over time and on successively performed divided attention test in Indian and Malaysian 1st-year medical students. Method: 60 Indian and 60 Malaysian first year medical students, with an equal number of girls and boys were randomized into two groups i.e music group and control group thus creating four subgroups. Three different forms of Symbol Digit Modality Test (to test concentration ability) were used as a pre-test, during music/control session and post-test. It was assessed using total, correct and error score. Simultaneously, multiple Blood Pressure recordings were taken as pre-test, during 1, 5, 15, 25 minutes during music/control (+SDMT) and post-test. The music group performed the test with classical instrumental background music while the control group performed it in silence. Results were analyzed using students paired t test. p value < 0.05 was taken as statistically significant. A drop in BP recording was indicative of relaxed state and a rise in BP with task performance was indicative of increased arousal. Results: In Symbol Digit Modality Test (SDMT) test, Music group showed significant better results for correct (p = 0.02) and total (p = 0.029) scores during post-test while errors reduced (p = 0.002). Indian music group showed decline in post-test error scores (p = 0.002). Malaysian music group performed significantly better in all categories. Blood pressure response was similar in music and control group with following variations, a drop in BP at 5minutes, being significant in music group (p < 0.001), a steep rise in values till 15minutes (corresponding to SDMT test) also being significant only in music group (p < 0.001) and the Systolic BP readings in controls during post-test were at lower levels compared to music group. On comparing the subgroups, not much difference was noticed in recordings of Indian student’s subgroups while all the paired-t test values in the Malaysian music group were significant. Conclusion: These recordings indicate an increased relaxed state with classical instrumental music and an increased arousal while performing a concentration task. Music used in our study was beneficial to students irrespective of their nationality and preference of music type. It can act as an “active coping” strategy and alleviate stress within a very short period of time, in our study within a span of 5minutes. When used in the background, during task performance, can increase arousal which helps the students perform better. Implications: Music can be used between lectures for a short time to relax the students and help them concentrate better for the subsequent classes, especially for late afternoon sessions.

Keywords: blood pressure, classical instrumental background music, ethnicity, symbol digit modality test

Procedia PDF Downloads 141
704 Lake Water Surface Variations and Its Influencing Factors in Tibetan Plateau in Recent 10 Years

Authors: Shanlong Lu, Jiming Jin, Xiaochun Wang

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The Tibetan Plateau has the largest number of inland lakes with the highest elevation on the planet. These massive and large lakes are mostly in natural state and are less affected by human activities. Their shrinking or expansion can truly reflect regional climate and environmental changes and are sensitive indicators of global climate change. However, due to the sparsely populated nature of the plateau and the poor natural conditions, it is difficult to effectively obtain the change data of the lake, which has affected people's understanding of the temporal and spatial processes of lake water changes and their influencing factors. By using the MODIS (Moderate Resolution Imaging Spectroradiometer) MOD09Q1 surface reflectance images as basic data, this study produced the 8-day lake water surface data set of the Tibetan Plateau from 2000 to 2012 at 250 m spatial resolution, with a lake water surface extraction method of combined with lake water surface boundary buffer analyzing and lake by lake segmentation threshold determining. Then based on the dataset, the lake water surface variations and their influencing factors were analyzed, by using 4 typical natural geographical zones of Eastern Qinghai and Qilian, Southern Qinghai, Qiangtang, and Southern Tibet, and the watersheds of the top 10 lakes of Qinghai, Siling Co, Namco, Zhari NamCo, Tangra Yumco, Ngoring, UlanUla, Yamdrok Tso, Har and Gyaring as the analysis units. The accuracy analysis indicate that compared with water surface data of the 134 sample lakes extracted from the 30 m Landsat TM (Thematic Mapper ) images, the average overall accuracy of the lake water surface data set is 91.81% with average commission and omission error of 3.26% and 5.38%; the results also show strong linear (R2=0.9991) correlation with the global MODIS water mask dataset with overall accuracy of 86.30%; and the lake area difference between the Second National Lake Survey and this study is only 4.74%, respectively. This study provides reliable dataset for the lake change research of the plateau in the recent decade. The change trends and influencing factors analysis indicate that the total water surface area of lakes in the plateau showed overall increases, but only lakes with areas larger than 10 km2 had statistically significant increases. Furthermore, lakes with area larger than 100 km2 experienced an abrupt change in 2005. In addition, the annual average precipitation of Southern Tibet and Southern Qinghai experienced significant increasing and decreasing trends, and corresponding abrupt changes in 2004 and 2006, respectively. The annual average temperature of Southern Tibet and Qiangtang showed a significant increasing trend with an abrupt change in 2004. The major reason for the lake water surface variation in Eastern Qinghai and Qilian, Southern Qinghai and Southern Tibet is the changes of precipitation, and that for Qiangtang is the temperature variations.

Keywords: lake water surface variation, MODIS MOD09Q1, remote sensing, Tibetan Plateau

Procedia PDF Downloads 231
703 India’s Energy Transition, Pathways for Green Economy

Authors: B. Sudhakara Reddy

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In modern economy, energy is fundamental to virtually every product and service in use. It has been developed on the dependence of abundant and easy-to-transform polluting fossil fuels. On one hand, increase in population and income levels combined with increased per capita energy consumption requires energy production to keep pace with economic growth, and on the other, the impact of fossil fuel use on environmental degradation is enormous. The conflicting policy objectives of protecting the environment while increasing economic growth and employment has resulted in this paradox. Hence, it is important to decouple economic growth from environmental degeneration. Hence, the search for green energy involving affordable, low-carbon, and renewable energies has become global priority. This paper explores a transition to a sustainable energy system using the socio-economic-technical scenario method. This approach takes into account the multifaceted nature of transitions which not only require the development and use of new technologies, but also of changes in user behaviour, policy and regulation. The scenarios that are developed are: baseline business as usual (BAU) as well as green energy (GE). The baseline scenario assumes that the current trends (energy use, efficiency levels, etc.) will continue in future. India’s population is projected to grow by 23% during 2010 –2030, reaching 1.47 billion. The real GDP, as per the model, is projected to grow by 6.5% per year on average between 2010 and 2030 reaching US$5.1 trillion or $3,586 per capita (base year 2010). Due to increase in population and GDP, the primary energy demand will double in two decades reaching 1,397 MTOE in 2030 with the share of fossil fuels remaining around 80%. The increase in energy use corresponds to an increase in energy intensity (TOE/US $ of GDP) from 0.019 to 0.036. The carbon emissions are projected to increase by 2.5 times from 2010 reaching 3,440 million tonnes with per capita emissions of 2.2 tons/annum. However, the carbon intensity (tons per US$ of GDP) decreases from 0.96 to 0.67. As per GE scenario, energy use will reach 1079 MTOE by 2030, a saving of about 30% over BAU. The penetration rate of renewable energy resources will reduce the total primary energy demand by 23% under GE. The reduction in fossil fuel demand and focus on clean energy will reduce the energy intensity to 0.21 (TOE/US$ of GDP) and carbon intensity to 0.42 (ton/US$ of GDP) under the GE scenario. The study develops new ‘pathways out of poverty’ by creating more than 10 million jobs and thus raise the standard of living of low-income people. Our scenarios are, to a great extent, based on the existing technologies. The challenges to this path lie in socio-economic-political domains. However, to attain a green economy the appropriate policy package should be in place which will be critical in determining the kind of investments that will be needed and the incidence of costs and benefits. These results provide a basis for policy discussions on investments, policies and incentives to be put in place by national and local governments.

Keywords: energy, renewables, green technology, scenario

Procedia PDF Downloads 248
702 The Touch Sensation: Ageing and Gender Influences

Authors: A. Abdouni, C. Thieulin, M. Djaghloul, R. Vargiolu, H. Zahouani

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A decline in the main sensory modalities (vision, hearing, taste, and smell) is well reported to occur with advancing age, it is expected a similar change to occur with touch sensation and perception. In this study, we have focused on the touch sensations highlighting ageing and gender influences with in vivo systems. The touch process can be divided into two main phases: The first phase is the first contact between the finger and the object, during this contact, an adhesive force has been created which is the needed force to permit an initial movement of the finger. In the second phase, the finger mechanical properties with their surface topography play an important role in the obtained sensation. In order to understand the age and gender effects on the touch sense, we develop different ideas and systems for each phase. To better characterize the contact, the mechanical properties and the surface topography of human finger, in vivo studies on the pulp of 40 subjects (20 of each gender) of four age groups of 26±3, 35+-3, 45+-2 and 58±6 have been performed. To understand the first touch phase a classical indentation system has been adapted to measure the finger contact properties. The normal force load, the indentation speed, the contact time, the penetration depth and the indenter geometry have been optimized. The penetration depth of a glass indenter is recorded as a function of the applied normal force. Main assessed parameter is the adhesive force F_ad. For the second phase, first, an innovative approach is proposed to characterize the dynamic finger mechanical properties. A contactless indentation test inspired from the techniques used in ophthalmology has been used. The test principle is to blow an air blast to the finger and measure the caused deformation by a linear laser. The advantage of this test is the real observation of the skin free return without any outside influence. Main obtained parameters are the wave propagation speed and the Young's modulus E. Second, negative silicon replicas of subject’s fingerprint have been analyzed by a probe laser defocusing. A laser diode transmits a light beam on the surface to be measured, and the reflected signal is returned to a set of four photodiodes. This technology allows reconstructing three-dimensional images. In order to study the age and gender effects on the roughness properties, a multi-scale characterization of roughness has been realized by applying continuous wavelet transform. After determining the decomposition of the surface, the method consists of quantifying the arithmetic mean of surface topographic at each scale SMA. Significant differences of the main parameters are shown with ageing and gender. The comparison between men and women groups reveals that the adhesive force is higher for women. The results of mechanical properties show a Young’s modulus higher for women and also increasing with age. The roughness analysis shows a significant difference in function of age and gender.

Keywords: ageing, finger, gender, touch

Procedia PDF Downloads 265
701 [Keynote Talk]: New Generations and Employment: An Exploratory Study about Tensions between the Psycho-Social Characteristics of the Generation Z and Expectations and Actions of Organizational Structures Related with Employment (CABA, 2016)

Authors: Esteban Maioli

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Generational studies have an important research tradition in social and human sciences. On the one hand, the speed of social change in the context of globalization imposes the need to research the transformations are identified both the subjectivity of the agents involved and its inclusion in the institutional matrix, specifically employment. Generation Z, (generally considered as the population group whose birth occurs after 1995) have unique psycho-social characteristics. Gen Z is characterized by a different set of values, beliefs, attitudes and ambitions that impact in their concrete action in organizational structures. On the other hand, managers often have to deal with generational differences in the workplace. Organizations have members who belong to different generations; they had never before faced the challenge of having such a diverse group of members. The members of each historical generation are characterized by a different set of values, beliefs, attitudes and ambitions that are manifest in their concrete action in organizational structures. Gen Z it’s the only one who can fully be considered "global," while its members were born in the consolidated context of globalization. Some salient features of the Generation Z can be summarized as follows. They’re the first fully born into a digital world. Social networks and technology are integrated into their lives. They are concerned about the challenges of the modern world (poverty, inequality, climate change, among others). They are self-expressive, more liberal and open to change. They often bore easily, with short attention spans. They do not like routine tasks. They want to achieve a good life-work balance, and they are interested in a flexible work environment, as opposed to traditional work schedule. They are critical thinkers, who come with innovative and creative ideas to help. Research design considered methodological triangulation. Data was collected with two techniques: a self-administered survey with multiple choice questions and attitudinal scales applied over a non-probabilistic sample by reasoned decision. According to the multi-method strategy, also it was conducted in-depth interviews. Organizations constantly face new challenges. One of the biggest ones is to learn to manage a multi-generational scope of work. While Gen Z has not yet been fully incorporated (expected to do so in five years or so), many organizations have already begun to implement a series of changes in its recruitment and development. The main obstacle to retaining young talent is the gap between the expectations of iGen applicants and what companies offer. Members of the iGen expect not only a good salary and job stability but also a clear career plan. Generation Z needs to have immediate feedback on their tasks. However, many organizations have yet to improve both motivation and monitoring practices. It is essential for companies to take a review of organizational practices anchored in the culture of the organization.

Keywords: employment, expectations, generation Z, organizational culture, organizations, psycho-social characteristics

Procedia PDF Downloads 201
700 Procedure for Monitoring the Process of Behavior of Thermal Cracking in Concrete Gravity Dams: A Case Study

Authors: Adriana de Paula Lacerda Santos, Bruna Godke, Mauro Lacerda Santos Filho

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Several dams in the world have already collapsed, causing environmental, social and economic damage. The concern to avoid future disasters has stimulated the creation of a great number of laws and rules in many countries. In Brazil, Law 12.334/2010 was created, which establishes the National Policy on Dam Safety. Overall, this policy requires the dam owners to invest in the maintenance of their structures and to improve its monitoring systems in order to provide faster and straightforward responses in the case of an increase of risks. As monitoring tools, visual inspections has provides comprehensive assessment of the structures performance, while auscultation’s instrumentation has added specific information on operational or behavioral changes, providing an alarm when a performance indicator exceeds the acceptable limits. These limits can be set using statistical methods based on the relationship between instruments measures and other variables, such as reservoir level, time of the year or others instruments measuring. Besides the design parameters (uplift of the foundation, displacements, etc.) the dam instrumentation can also be used to monitor the behavior of defects and damage manifestations. Specifically in concrete gravity dams, one of the main causes for the appearance of cracks, are the concrete volumetric changes generated by the thermal origin phenomena, which are associated with the construction process of these structures. Based on this, the goal of this research is to propose a monitoring process of the thermal cracking behavior in concrete gravity dams, through the instrumentation data analysis and the establishment of control values. Therefore, as a case study was selected the Block B-11 of José Richa Governor Dam Power Plant, that presents a cracking process, which was identified even before filling the reservoir in August’ 1998, and where crack meters and surface thermometers were installed for its monitoring. Although these instruments were installed in May 2004, the research was restricted to study the last 4.5 years (June 2010 to November 2014), when all the instruments were calibrated and producing reliable data. The adopted method is based on simple linear correlations procedures to understand the interactions among the instruments time series, verifying the response times between them. The scatter plots were drafted from the best correlations, which supported the definition of the limit control values. Among the conclusions, it is shown that there is a strong or very strong correlation between ambient temperature and the crack meters and flowmeters measurements. Based on the results of the statistical analysis, it was possible to develop a tool for monitoring the behavior of the case study cracks. Thus it was fulfilled the goal of the research to develop a proposal for a monitoring process of the behavior of thermal cracking in concrete gravity dams.

Keywords: concrete gravity dam, dams safety, instrumentation, simple linear correlation

Procedia PDF Downloads 292
699 Cardiac Rehabilitation Program and Health-Related Quality of Life; A Randomized Control Trial

Authors: Zia Ul Haq, Saleem Muhammad, Naeem Ullah, Abbas Shah, Abdullah Shah

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Pakistan being the developing country is facing double burden of communicable and non-communicable disease. The aspect of secondary prevention of ischemic heart disease in developing countries is the dire need for public health specialists, clinicians and policy makers. There is some evidence that psychotherapeutic measures, including psychotherapy, recreation, exercise and stress management training have positive impact on secondary prevention of cardiovascular diseases but there are some contradictory findings as well. Cardiac rehabilitation program (CRP) has not yet fully implemented in Pakistan. Psychological, physical and specific health-related quality of life (HRQoL) outcomes needs assessment with respect to its practicality, effectiveness, and success. Objectives: To determine the effect of cardiac rehabilitation program (CRP) on the health-related quality of life (HRQoL) measures of post MI patients compared to the usual care. Hypothesis: Post MI patients who receive the interventions (CRP) will have better HRQoL as compared to those who receive the usual cares. Methods: The randomized control trial was conducted at a Cardiac Rehabilitation Unit of Lady Reading Hospital (LRH), Peshawar. LRH is the biggest hospital of the Province Khyber Pakhtunkhwa (KP). A total 206 participants who had recent first myocardial infarction were inducted in the study. Participants were randomly allocated into two group i.e. usual care group (UCG) and cardiac rehabilitation group (CRG) by permuted-block randomization (PBR) method. CRP was conducted in CRG in two phases. Three HRQoL outcomes i.e. general health questionnaire (GHQ), self-rated health (SRH) and MacNew quality of life after myocardial infarction (MacNew QLMI) were assessed at baseline and follow-up visits among both groups. Data were entered and analyzed by appropriate statistical test in STATA version 12. Results: A total of 195 participants were assessed at the follow-up period due to lost-to-follow-up. The mean age of the participants was 53.66 + 8.3 years. Males were dominant in both groups i.e. 150 (76.92%). Regarding educational status, majority of the participants were illiterate in both groups i.e. 128 (65.64%). Surprisingly, there were 139 (71.28%) who were non-smoker on the whole. The comorbid status was positive in 120 (61.54%) among all the patients. The SRH at follow-up among UCG and CRG was 4.06 (95% CI: 3.93, 4.19) and 2.36 (95% CI: 2.2, 2.52) respectively (p<0.001). GHQ at the follow-up of UCG and CRG was 20.91 (95% CI: 18.83, 21.97) and 7.43 (95% CI: 6.59, 8.27) respectively (p<0.001). The MacNew QLMI at follow-up of UCG and CRG was 3.82 (95% CI: 3.7, 3.94) and 5.62 (95% CI: 5.5, 5.74) respectively (p<0.001). All the HRQoL measures showed strongly significant improvement in the CRG at follow-up period. Conclusion: HRQOL improved in post MI patients after comprehensive CRP. Education of the patients and their supervision is needed when they are involved in their rehabilitation activities. It is concluded that establishing CRP in cardiac units, recruiting post-discharged MI patients and offering them CRP does not impose high costs and can result in significant improvement in HRQoL measures. Trial registration no: ACTRN12617000832370

Keywords: cardiovascular diseases, cardiac rehabilitation, health-related quality of life, HRQoL, myocardial infarction, quality of life, QoL, rehabilitation, randomized control trial

Procedia PDF Downloads 227
698 Harnessing Sunlight for Clean Water: Scalable Approach for Silver-Loaded Titanium Dioxide Nanoparticles

Authors: Satam Alotibi, Muhammad J. Al-Zahrani, Fahd K. Al-Naqidan, Turki S. Hussein, Moteb Alotaibi, Mohammed Alyami, Mahdy M. Elmahdy, Abdellah Kaiba, Fatehia S. Alhakami, Talal F. Qahtan

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Water pollution is a critical global challenge that demands scalable and effective solutions for water decontamination. In this captivating research, we unveil a groundbreaking strategy for harnessing solar energy to synthesize silver (Ag) clusters on stable titanium dioxide (TiO₂) nanoparticles dispersed in water, without the need for traditional stabilization agents. These Ag-loaded TiO₂ nanoparticles exhibit exceptional photocatalytic activity, surpassing that of pristine TiO₂ nanoparticles, offering a promising solution for highly efficient water decontamination under sunlight irradiation. To the best knowledge, we have developed a unique method to stabilize TiO₂ P25 nanoparticles in water without the use of stabilization agents. This breakthrough allows us to create an ideal platform for the solar-driven synthesis of Ag clusters. Under sunlight irradiation, the stable dispersion of TiO₂ P25 nanoparticles acts as a highly efficient photocatalyst, generating electron-hole pairs. The photogenerated electrons effectively reduce silver ions derived from a silver precursor, resulting in the formation of Ag clusters. The Ag clusters loaded on TiO₂ P25 nanoparticles exhibit remarkable photocatalytic activity for water decontamination under sunlight irradiation. Acting as active sites, these Ag clusters facilitate the generation of reactive oxygen species (ROS) upon exposure to sunlight. These ROS play a pivotal role in rapidly degrading organic pollutants, enabling efficient water decontamination. To confirm the success of our approach, we characterized the synthesized Ag-loaded TiO₂ P25 nanoparticles using cutting-edge analytical techniques, such as transmission electron microscopy (TEM), scanning electron microscopy (SEM), X-ray diffraction (XRD), and spectroscopic methods. These characterizations unequivocally confirm the successful synthesis of Ag clusters on stable TiO₂ P25 nanoparticles without traditional stabilization agents. Comparative studies were conducted to evaluate the superior photocatalytic performance of Ag-loaded TiO₂ P25 nanoparticles compared to pristine TiO₂ P25 nanoparticles. The Ag clusters loaded on TiO₂ P25 nanoparticles exhibit significantly enhanced photocatalytic activity, benefiting from the synergistic effect between the Ag clusters and TiO₂ nanoparticles, which promotes ROS generation for efficient water decontamination. Our scalable strategy for synthesizing Ag clusters on stable TiO₂ P25 nanoparticles without stabilization agents presents a game-changing solution for highly efficient water decontamination under sunlight irradiation. The use of commercially available TiO₂ P25 nanoparticles streamlines the synthesis process and enables practical scalability. The outstanding photocatalytic performance of Ag-loaded TiO₂ P25 nanoparticles opens up new avenues for their application in large-scale water treatment and remediation processes, addressing the urgent need for sustainable water decontamination solutions.

Keywords: water pollution, solar energy, silver clusters, TiO₂ nanoparticles, photocatalytic activity

Procedia PDF Downloads 69
697 Starting the Hospitalization Procedure with a Medicine Combination in the Cardiovascular Department of the Imam Reza (AS) Mashhad Hospital

Authors: Maryamsadat Habibi

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Objective: pharmaceutical errors are avoidable occurrences that can result in inappropriate pharmaceutical use, patient harm, treatment failure, increased hospital costs and length of stay, and other outcomes that affect both the individual receiving treatment and the healthcare provider. This study aimed to perform a reconciliation of medications in the cardiovascular ward of Imam Reza Hospital in Mashhad, Iran, and evaluate the prevalence of medication discrepancies between the best medication list created for the patient by the pharmacist and the medication order of the treating physician there. Materials & Methods: The 97 patients in the cardiovascular ward of the Imam Reza Hospital in Mashhad were the subject of a cross-sectional study from June to September of 2021. After giving their informed consent and being admitted to the ward, all patients with at least one underlying condition and at least two medications being taken at home were included in the study. A medical reconciliation form was used to record patient demographics and medical histories during the first 24 hours of admission, and the information was contrasted with the doctors' orders. The doctor then discovered medication inconsistencies between the two lists and double-checked them to separate the intentional from the accidental anomalies. Finally, using SPSS software version 22, it was determined how common medical discrepancies are and how different sorts of discrepancies relate to various variables. Results: The average age of the participants in this study was 57.6915.84 years, with 57.7% of men and 42.3% of women. 95.9% of the patients among these people encountered at least one medication discrepancy, and 58.9% of them suffered at least one unintentional drug cessation. Out of the 659 medications registered in the study, 399 cases (60.54%) had inconsistencies, of which 161 cases (40.35%) involved the intentional stopping of a medication, 123 cases (30.82%) involved the stopping of a medication unintentionally, and 115 cases (28.82%) involved the continued use of a medication by adjusting the dose. Additionally, the category of cardiovascular pharmaceuticals and the category of gastrointestinal medications were found to have the highest medical inconsistencies in the current study. Furthermore, there was no correlation between the frequency of medical discrepancies and the following variables: age, ward, date of visit, type, and number of underlying diseases (P=0.13), P=0.61, P=0.72, P=0.82, P=0.44, and so forth. On the other hand, there was a statistically significant correlation between the number of medications taken at home (P=0.037) and the prevalence of medical discrepancies with gender (P=0.029). The results of this study revealed that 96% of patients admitted to the cardiovascular unit at Imam Reza Hospital had at least one medication error, which was typically an intentional drug discontinuance. According to the study's findings, patients admitted to Imam Reza Hospital's cardiovascular ward have a great potential for identifying and correcting various medication discrepancies as well as for avoiding prescription errors when the medication reconciliation method is used. As a result, it is essential to carry out a precise assessment to achieve the best treatment outcomes and avoid unintended medication discontinuation, unwanted drug-related events, and drug interactions between the patient's home medications and those prescribed in the hospital.

Keywords: drug combination, drug side effects, drug incompatibility, cardiovascular department

Procedia PDF Downloads 88
696 Killing for the Great Peace: An Internal Perspective on the Anti-Manchu Theme in the Taiping Movement

Authors: Zihao He

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The majority of existing studies on the Taiping Movement (1851-1864) viewed their anti-Manchu attitudes as nationalist agendas: Taiping was aimed at revolting against the Manchu government and establishing a new political regime. To explain these aggressive and violent attitudes towards Manchu, these studies mainly found socio-economic factors and stressed the status of “being deprived”. Even the ‘demon-slaying’ narrative of the Taiping to dehumanize the Manchu tends to be viewed as a “religious tool” to achieve their political, nationalist aim. This paper argues that these studies on Taiping’s anti-Manchu attitudes and behaviors are analyzed from an external angle and have two major problems. Firstly, they distinguished “religion” from “nationalist” or “political”, focusing on the “political” nature of the movement. “Religion” and the religious experience within Taiping were largely ignored. This paper argues that there was no separable and independent “religion” in the Taiping Movement, as opposed to secular, nationalist politics. Secondly, these analyses held an external perspective on Taiping’s anti-Manchu agenda. Demonizing and killing Manchu were viewed as purely political actions. On the contrary, this paper focuses on the internal perspective of anti-Manchu narratives in the Taiping Movement. The method of this paper is mainly textual analysis, focusing on the official documents, edicts, and proclamations of the Taiping movement. It views the writing of the Taiping as a coherent narrative and rhetoric, which was attractive and convincing for its followers. In terms of the main findings, firstly, internal and external perspectives on anti-Manchu violence are different. Externally, violence was viewed as a tool and necessary process to achieve the political goal. However, internally speaking, in Taiping’s writing, violence was a result of Godlessness, which would be solved as far as the faith in God is restored in China. Having a framework of universal love among human beings as sons and daughters of the Heavenly Father and killing was forbidden, the Taiping excluded Manchus from the family of human beings and demonized them. “Demon-slaying” was not violence. It was constructed as a necessary process to achieve the Great Peace. Moreover, Taiping’s anti-Manchu violence was not merely “political.” Rather, the category “religion” and its binary opposition, “secular,” is not suitable for Taiping. A key point related to this argument is the revolutionary violence against the Manchu government, which inherited the traditional “Heavenly Mandate” model. From an internal, theological perspective, anti-Manchu was ordained and commanded by the Heavenly Father. Manchu, as a regime, was standing as a hindrance in the path toward God. Besides, Manchu was not only viewed as a regime, but they were also “demons.” Therefore, the paper examines how Manchus were dehumanized in Taiping’s writings and were situated outside of the consideration of nonviolent and love. Manchu as a regime and Manchu as demons are in a dynamic relationship. As a regime, the Manchu government was preventing Chinese people from worshipping the Heavenly Father, so they were demonized. As they were demons, killing Manchus during the revolt was justified and not viewed as being contradicted the universal love among human beings.

Keywords: anti-manchu, demon-slaying, heavenly mandate, religion and violence, the taiping movement.

Procedia PDF Downloads 71
695 Physicochemical-Mechanical, Thermal and Rheological Properties Analysis of Pili Tree (Canarium Ovatum) Resin as Aircraft Integral Fuel Tank Sealant

Authors: Mark Kennedy, E. Bantugon, Noruane A. Daileg

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Leaks arising from aircraft fuel tanks is a protracted problem for the aircraft manufacturers, operators, and maintenance crews. It principally arises from stress, structural defects, or degraded sealants as the aircraft age. It can be ignited by different sources, which can result in catastrophic flight and consequences, exhibiting a major drain both on time and budget. In order to mitigate and eliminate this kind of problem, the researcher produced an experimental sealant having a base material of natural tree resin, the Pili Tree Resin. Aside from producing an experimental sealant, the main objective of this research is to analyze its physical, chemical, mechanical, thermal, and rheological properties, which is beneficial and effective for specific aircraft parts, particularly the integral fuel tank. The experimental method of research was utilized in this study since it is a product invention. This study comprises two parts, specifically the Optimization Process and the Characterization Process. In the Optimization Process, the experimental sealant was subjected to the Flammability Test, an important test and consideration according to 14 Code of Federal Regulation Appendix N, Part 25 - Fuel Tank Flammability Exposure and Reliability Analysis, to get the most suitable formulation. Followed by the Characterization Process, where the formulated experimental sealant has undergone thirty-eight (38) different standard testing including Organoleptic, Instrumental Color Measurement Test, Smoothness of Appearance Test, Miscibility Test, Boiling Point Test, Flash Point Test, Curing Time, Adhesive Test, Toxicity Test, Shore A Hardness Test, Compressive Strength, Shear Strength, Static Bending Strength, Tensile Strength, Peel Strength Test, Knife Test, Adhesion by Tape Test, Leakage Test), Drip Test, Thermogravimetry-Differential Thermal Analysis (TG-DTA), Differential Scanning Calorimetry, Calorific Value, Viscosity Test, Creep Test, and Anti-Sag Resistance Test to determine and analyze the five (5) material properties of the sealant. The numerical values of the mentioned tests are determined using product application, testing, and calculation. These values are then used to calculate the efficiency of the experimental sealant. Accordingly, this efficiency is the means of comparison between the experimental and commercial sealant. Based on the results of the different standard testing conducted, the experimental sealant exceeded all the data results of the commercial sealant. This result shows that the physicochemical-mechanical, thermal, and rheological properties of the experimental sealant are far more effective as an aircraft integral fuel tank sealant alternative in comparison to the commercial sealant. Therefore, Pili Tree possesses a new role and function: a source of ingredients in sealant production.

Keywords: Aircraft Integral Fuel Tank, Physicochemi-mechanical, Pili Tree Resin, Properties, Rheological, Sealant, Thermal

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694 Machine Learning Approaches Based on Recency, Frequency, Monetary (RFM) and K-Means for Predicting Electrical Failures and Voltage Reliability in Smart Cities

Authors: Panaya Sudta, Wanchalerm Patanacharoenwong, Prachya Bumrungkun

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As With the evolution of smart grids, ensuring the reliability and efficiency of electrical systems in smart cities has become crucial. This paper proposes a distinct approach that combines advanced machine learning techniques to accurately predict electrical failures and address voltage reliability issues. This approach aims to improve the accuracy and efficiency of reliability evaluations in smart cities. The aim of this research is to develop a comprehensive predictive model that accurately predicts electrical failures and voltage reliability in smart cities. This model integrates RFM analysis, K-means clustering, and LSTM networks to achieve this objective. The research utilizes RFM analysis, traditionally used in customer value assessment, to categorize and analyze electrical components based on their failure recency, frequency, and monetary impact. K-means clustering is employed to segment electrical components into distinct groups with similar characteristics and failure patterns. LSTM networks are used to capture the temporal dependencies and patterns in customer data. This integration of RFM, K-means, and LSTM results in a robust predictive tool for electrical failures and voltage reliability. The proposed model has been tested and validated on diverse electrical utility datasets. The results show a significant improvement in prediction accuracy and reliability compared to traditional methods, achieving an accuracy of 92.78% and an F1-score of 0.83. This research contributes to the proactive maintenance and optimization of electrical infrastructures in smart cities. It also enhances overall energy management and sustainability. The integration of advanced machine learning techniques in the predictive model demonstrates the potential for transforming the landscape of electrical system management within smart cities. The research utilizes diverse electrical utility datasets to develop and validate the predictive model. RFM analysis, K-means clustering, and LSTM networks are applied to these datasets to analyze and predict electrical failures and voltage reliability. The research addresses the question of how accurately electrical failures and voltage reliability can be predicted in smart cities. It also investigates the effectiveness of integrating RFM analysis, K-means clustering, and LSTM networks in achieving this goal. The proposed approach presents a distinct, efficient, and effective solution for predicting and mitigating electrical failures and voltage issues in smart cities. It significantly improves prediction accuracy and reliability compared to traditional methods. This advancement contributes to the proactive maintenance and optimization of electrical infrastructures, overall energy management, and sustainability in smart cities.

Keywords: electrical state prediction, smart grids, data-driven method, long short-term memory, RFM, k-means, machine learning

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693 Patterns and Predictors of Intended Service Use among Frail Older Adults in Urban China

Authors: Yuanyuan Fu

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Background and Purpose: Along with the change of society and economy, the traditional home function of old people has gradually weakened in the contemporary China. Acknowledging these situations, to better meet old people’s needs on formal services and improve the quality of later life, this study seeks to identify patterns of intended service use among frail old people living in the communities and examined determinants that explain heterogeneous variations in old people’s intended service use patterns. Additionally, this study also tested the relationship between culture value and intended service use patterns and the mediating role of enabling factors in terms of culture value and intended service use patterns. Methods:Participants were recruited from Haidian District, Beijing, China in 2015. The multi-stage sampling method was adopted to select sub-districts, communities and old people aged 70 years old or older. After screening, 577 old people with limitations in daily life, were successfully interviewed. After data cleaning, 550 samples were included for data analysis. This study establishes a conceptual framework based on the Anderson Model (including predisposing factors, enabling factors and need factors), and further developed it by adding culture value factors (including attitudes towards filial piety and attitudes towards social face). Using a latent class analysis (LCA), this study classifies overall patterns of old people’s formal service utilization. Fourteen types of formal services were taken into account, including housework, voluntary support, transportation, home-delivered meals, and home-delivery medical care, elderly’s canteen and day-care center/respite care and so on. Structural equation modeling (SEM) was used to examine the direct effect of culture value on service use pattern, and the mediating effect of the enabling factors. Results: The LCA classified a hierarchical structure of service use patterns: multiple intended service use (N=69, 23%), selective intended service use (N=129, 23%), and light intended service use (N=352, 64%). Through SEM, after controlling predisposing factors and need factors, the results showed the significant direct effect of culture value on older people’s intended service use patterns. Enabling factors had a partial mediation effect on the relationship between culture value and the patterns. Conclusions and Implications: Differentiation of formal services may be important for meeting frail old people’s service needs and distributing program resources by identifying target populations for intervention, which may make reference to specific interventions to better support frail old people. Additionally, culture value had a unique direct effect on the intended service use patterns of frail old people in China, enriching our theoretical understanding of sources of culture value and their impacts. The findings also highlighted the mediation effects of enabling factors on the relationship between culture value factors and intended service use patterns. This study suggests that researchers and service providers should pay more attention to the important role of culture value factors in contributing to intended service use patterns and also be more sensitive to the mediating effect of enabling factors when discussing the relationship between culture value and the patterns.

Keywords: frail old people, intended service use pattern, culture value, enabling factors, contemporary China, latent class analysis

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692 Application of NBR 14861: 2011 for the Design of Prestress Hollow Core Slabs Subjected to Shear

Authors: Alessandra Aparecida Vieira França, Adriana de Paula Lacerda Santos, Mauro Lacerda Santos Filho

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The purpose of this research i to study the behavior of precast prestressed hollow core slabs subjected to shear. In order to achieve this goal, shear tests were performed using hollow core slabs 26,5cm thick, with and without a concrete cover of 5 cm, without cores filled, with two cores filled and three cores filled with concrete. The tests were performed according to the procedures recommended by FIP (1992), the EN 1168:2005 and following the method presented in Costa (2009). The ultimate shear strength obtained within the tests was compared with the values of theoretical resistant shear calculated in accordance with the codes, which are being used in Brazil, noted: NBR 6118:2003 and NBR 14861:2011. When calculating the shear resistance through the equations presented in NBR 14861:2011, it was found that provision is much more accurate for the calculation of the shear strength of hollow core slabs than the NBR 6118 code. Due to the large difference between the calculated results, even for slabs without cores filled, the authors consulted the committee that drafted the NBR 14861:2011 and found that there is an error in the text of the standard, because the coefficient that is suggested, actually presents the double value than the needed one! The ABNT, later on, soon issued an amendment of NBR 14861:2011 with the necessary corrections. During the tests for the present study, it was confirmed that the concrete filling the cores contributes to increase the shear strength of hollow core slabs. But in case of slabs 26,5 cm thick, the quantity should be limited to a maximum of two cores filled, because most of the results for slabs with three cores filled were smaller. This confirmed the recommendation of NBR 14861:2011which is consistent with standard practice. After analyzing the configuration of cracking and failure mechanisms of hollow core slabs during the shear tests, strut and tie models were developed representing the forces acting on the slab at the moment of rupture. Through these models the authors were able to calculate the tensile stress acting on the concrete ties (ribs) and scaled the geometry of these ties. The conclusions of the research performed are the experiments results have shown that the mechanism of failure of the hollow-core slabs can be predicted using the strut-and-tie procedure, within a good range of accuracy. In addition, the needed of the correction of the Brazilian standard to review the correction factor σcp duplicated (in NBR14861/2011), and the limitation of the number of cores (Holes) to be filled with concrete, to increase the strength of the slab for the shear resistance. It is also suggested the increasing the amount of test results with 26.5 cm thick, and a larger range of thickness slabs, in order to obtain results of shear tests with cores concreted after the release of prestressing force. Another set of shear tests on slabs must be performed in slabs with cores filled and cover concrete reinforced with welded steel mesh for comparison with results of theoretical values calculated by the new revision of the standard NBR 14861:2011.

Keywords: prestressed hollow core slabs, shear, strut, tie models

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691 A Smart Sensor Network Approach Using Affordable River Water Level Sensors

Authors: Dian Zhang, Brendan Heery, Maria O’Neill, Ciprian Briciu-Burghina, Noel E. O’Connor, Fiona Regan

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Recent developments in sensors, wireless data communication and the cloud computing have brought the sensor web to a whole new generation. The introduction of the concept of ‘Internet of Thing (IoT)’ has brought the sensor research into a new level, which involves the developing of long lasting, low cost, environment friendly and smart sensors; new wireless data communication technologies; big data analytics algorithms and cloud based solutions that are tailored to large scale smart sensor network. The next generation of smart sensor network consists of several layers: physical layer, where all the smart sensors resident and data pre-processes occur, either on the sensor itself or field gateway; data transmission layer, where data and instructions exchanges happen; the data process layer, where meaningful information is extracted and organized from the pre-process data stream. There are many definitions of smart sensor, however, to summarize all these definitions, a smart sensor must be Intelligent and Adaptable. In future large scale sensor network, collected data are far too large for traditional applications to send, store or process. The sensor unit must be intelligent that pre-processes collected data locally on board (this process may occur on field gateway depends on the sensor network structure). In this case study, three smart sensing methods, corresponding to simple thresholding, statistical model and machine learning based MoPBAS method, are introduced and their strength and weakness are discussed as an introduction to the smart sensing concept. Data fusion, the integration of data and knowledge from multiple sources, are key components of the next generation smart sensor network. For example, in the water level monitoring system, weather forecast can be extracted from external sources and if a heavy rainfall is expected, the server can send instructions to the sensor notes to, for instance, increase the sampling rate or switch on the sleeping mode vice versa. In this paper, we describe the deployment of 11 affordable water level sensors in the Dublin catchment. The objective of this paper is to use the deployed river level sensor network at the Dodder catchment in Dublin, Ireland as a case study to give a vision of the next generation of a smart sensor network for flood monitoring to assist agencies in making decisions about deploying resources in the case of a severe flood event. Some of the deployed sensors are located alongside traditional water level sensors for validation purposes. Using the 11 deployed river level sensors in a network as a case study, a vision of the next generation of smart sensor network is proposed. Each key component of the smart sensor network is discussed, which hopefully inspires the researchers who are working in the sensor research domain.

Keywords: smart sensing, internet of things, water level sensor, flooding

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690 A Comparative Study of the Impact of the Total Fertility Rate (TFR) on Trends in the Second Demographic Transition in Rwanda

Authors: Etienne Gatera

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Many studies have been conducted on SDT. Most of them focus on developed countries because of influencing factors such as; education, health, labor force, female labor force participation, industrialization, urbanization and migration. However, this thesis project paper aims to assess the impact of the total fertility rate (TFR) on the trends of the SDR in Rwanda. We will mainly be based in Rwanda after the 1994 genocide. Rwanda is located in East Africa, with approximately 13 million inhabitants. Thus, after the 1994 Tutsi genocide. The population growth rate exploded out of control with 6.17 children per woman in 1995. However, it's declined to 4.2 in 2014-2015 and declining to 4.1% in 2019-2020. Respectively with 3.4 children per woman in urban areas and 4.3 in rural areas. According to the National Institute of Statistics of Rwanda. Rwanda's population is expected to continue to grow for the rest of the century and reach 33.35 million people in 2099, with 2.1 children per woman in 2050. However, this project document aims to demonstrate the impact of the TFR on SDT trends in Rwanda. Thus, the decline in the TFR in Rwanda began with the introduction of family planning practices, which now account for 47.5% in 2019. Childbearing with three children for rural women compared to two children in the city, the increase in Divorce and separation caused by the behavior called "Kuza n'ijoro" or "coming at night" similar to cohabitation in developed countries. The decline in remarriage is caused by single mothers behavior who prefer to raise their children rather than remarry. Therefore, the study used probability sampling with (Stratified random sampling) method with a survey questionnaire of 1067 respondents in the 5 Districts (3 in rural areas and two in urban areas), with the target group of women Age between 15-49. The study demonstrated that the age of marriage in rural areas is two years higher than in urban areas. Divorce is more common in urban is with 6.2% with 5.2% in rural areas. However, separation is more common in rural areas than in urban areas, with a lower rate of 3%, due to the higher system called "Kuza n'ijoro" or "come at night", similar to cohabitation in developed countries. The study revealed that more than 85% of divorced people prefer to remain single, which confirms the low remarriage rate. Childbearing has started to decrease, especially for young singles in urban areas, due to the economic situation, with national statistics showing that unemployment in the youth community is still 16% higher. Therefore, the study concluded by confirming the hypothesis based on the results of the TFR indicators such as marriage, remarriage, divorce, separation, divorce, Kuza n'ijoro, childbearing] and abortion. The study consists of four sections, an introduction and background, a review of the literature, a description of the data and methodology, an analysis of the data, discussion results and a conclusion.

Keywords: Kuza n'ijoro, Rwanda, second demographic transition (SDT), total fertility rate (TFR)

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689 Managing Type 1 Diabetes in College: A Thematic Analysis of Online Narratives Posted on YouTube

Authors: Ekaterina Malova

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Type 1 diabetes (T1D) is a chronic illness requiring immense lifestyle changes to reduce the chance of life-threatening complications. Moving to a college may be the first time for a young adult with T1D to take responsibility for all the aspects of their diabetes care. In addition, people with T1D constantly face stigmatization and discrimination as a result of their health condition, which puts additional pressure on young adults with T1D. Hence, omissions in diabetes self-care often occur during the time of transition to college when both the social and physical environment of young adults changes drastically and contribute to the fact that emerging young adults remain one of the age groups with the highest hemoglobin levels and poorest diabetes control. However, despite potential severe health risks caused by a lack of proper diabetes self-care, little is known about the experiences of emerging adults embarking on a higher education journey as this population. Thus, young adults with type 1 diabetes are a 'forgotten group,' meaning that their experiences are rarely addressed by researchers. Given that self-disclosure and information-seeking can be challenging for individuals with stigmatized illnesses, online platforms like YouTube have become a popular medium of self-disclosure and information-seeking for people living with T1D. Thus, this study aims to provide an analysis of experiences that college students with T1D choose to share with the general public online and explore the nature of information being communicated by college students with T1D to the online community in personal narratives posted on YouTube. A systematic approach was used to retrieve a video sample by searching YouTube with keywords 'type 1 diabetes' and 'college,' with results ordered by relevance. A total of 18 videos were saved. Video lengths ranged from 2 to 28 minutes. The data were coded using NVivo. Video transcripts were coded and analyzed utilizing the thematic analysis method. Three key themes emerged from thematic analysis: 1) Advice, 2) Personal experience, and 3) Things I wish everyone knew about T1D. In addition, Theme 1 was divided into subtopics to differentiate between the most common types of advice: 1) Overcoming stigma and b) Seeking social support. The identified themes indicate that two groups of the population can potentially benefit from watching students’ video testimonies: 1) lay public and 2) other students with T1D. Given that students in the videos reported a lack of T1D education in the lay public, such video narratives can serve important educational purposes and reduce health stigma, while perceived similarity and identification with students in the videos may facilitate the transition of health information to other individuals with T1D and positively affect their diabetes routine. Thus, online video narratives can potentially serve both educational and persuasive purposes, empowering students with T1D to stay in control of T1D while succeeding academically.

Keywords: type 1 diabetes, college students, health communication, transition period

Procedia PDF Downloads 154