Search results for: assessing pain
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2717

Search results for: assessing pain

857 Assessing Water Bottle Consumption on College Campus in Abu Dhabi: Towards a Sustainable Future

Authors: Ludmilla Wikkeling-Scott, Amira Karim

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Background: In a rapidly developing environment, concerns for pollution and depletion of natural resources are challenges facing global communities. A major source of waste on university campuses is the use of plastic bottles, while cost of production and processing is high. Consumer demand stimulates popularity of plastic bottle production, but researchers agree this is not a sustainable solution. This pilot study assesses plastic water bottle used and attitude towards alternatives among Emirati college students. Methods: This study was conducted in December 2016, using an anonymous self-administered survey of 17 questions. The survey included personal characteristics, plastic water bottle used, attitude towards alternative replacement and sustainability. For statistical analysis, STATA 14C was used to determine significance of association. Results: A total of 500 Emirati students (94.6% female) completed the survey. Of the students, 82.6% preferred bottled water over tap water, and 44.6% reported disposable bottled water use in their household, 42.6% purchased disposable bottled water more than twice a week, and 44.2% purchased bottled water at least once, while on campus. Students were willing to consider switching to alternative water bottle use if it was more convenient (22.54%), cost less (55.13%) or improved the taste (22.54%), while only 7.85% students would not consider any alternatives. There was a significant difference in attitude towards alternatives to water bottle use by area of study (p < 0.005). Conclusion: The UAE strives to be at the forefront of sustainable development and protecting biodiversity. However, a major challenge is the increasing amount of waste, exacerbated by the increasing consumer demand for convenience as seen in this billion-dollar industry. Plastic bottles, for all purposes, pose a serious threat to the environment and sustainable campus initiatives can help reduce the ecological footprint, improve awareness of safe alternatives and benefits to the environment.

Keywords: ecological foot print, emirati students, plastic bottle consumption, sustainable campus

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856 Assessing the Impact of Construction Projects on Disabled Accessibility and Inclusion

Authors: Yasser Aboel-Magd

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This research addresses the critical issue of accessibility for individuals with special needs and the broader implications of disability on one's ability to lead an independent and integrated life within society. It highlights the consequences of injury, illness, or disability not only on the physical level but also on psychological, social, educational, economic, and functional aspects of life. The study emphasizes the importance of inclusive design in urban spaces, reflecting on how a society's treatment of individuals with disabilities serves as a measure of its progress. The research delves into the challenges faced by people with special needs in the Kingdom, where, despite advancements in various sectors, there is a noticeable lack of accommodating public opportunities for this significant demographic. It argues for the necessity of a Saudi building code that considers the needs of a diverse population during the design phase. The paper discusses the role of urban space as a fundamental element in urban formation and its impact on the societal integration of individuals with special needs. The study explores a variety of inclusive design principles, ranging from physical features like ramps and tactile paving to digital and cognitive accessibility measures such as screen readers, closed captions, plain language, and visual aids. It also considers the impact of wayfinding and appropriate lighting design on the orientation and assistance of individuals within urban spaces at the lowest cost. The researchers connect inclusive design with sustainable practices, advocating for environments that are not only environmentally friendly but also adaptable and lasting. The paper concludes with the assertion that the integration of accessibility, universal design, and sustainability signifies a society's commitment to inclusivity and the empowerment of all individuals, paving the way for a future where everyone can participate fully and independently in society.

Keywords: accessibility, inclusive design, Saudi building code, disability inclusion, socioeconomic progress

Procedia PDF Downloads 77
855 Psychometric Properties of the Social Skills Rating System: Teacher Version

Authors: Amani Kappi, Ana Maria Linares, Gia Mudd-Martin

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Children with Attention Deficit Hyperactivity Disorder (ADHD) are more likely to develop social skills deficits that can lead to academic underachievement, peer rejection, and maladjustment. Surveying teachers about children's social skills with ADHD will become a significant factor in identifying whether the children will be diagnosed with social skills deficits. The teacher-specific version of the Social Skills Rating System scale (SSRS-T) has been used as a screening tool for children's social behaviors. The psychometric properties of the SSRS-T have been evaluated in various populations and settings, such as when used by teachers to assess social skills for children with learning disabilities. However, few studies have been conducted to examine the psychometric properties of the SSRS-T when used to assess children with ADHD. The purpose of this study was to examine the psychometric properties of the SSRS-T and two SSRS-T subscales, Social Skills and Problem Behaviors. This was a secondary analysis of longitudinal data from the Fragile Families and Child Well-Being Study. This study included a sample of 194 teachers who used the SSRS-T to assess the social skills of children aged 8 to 10 years with ADHD. Exploratory principal components factor analysis was used to assess the construct validity of the SSRS-T scale. Cronbach’s alpha value was used to assess the internal consistency reliability of the total SSRS-T scale and the subscales. Item analyses included item-item intercorrelations, item-to-subscale correlations, and Cronbach’s alpha value changes with item deletion. The results of internal consistency reliability for both the total scale and subscales were acceptable. The results of the exploratory factor analysis supported the five factors of SSRS-T (Cooperation, Self-control, Assertion, Internalize behaviors, and Externalize behaviors) reported in the original version. Findings indicated that SSRS-T is a reliable and valid tool for assessing the social behaviors of children with ADHD.

Keywords: ADHD, children, social skills, SSRS-T, psychometric properties

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854 A Theory-Based Analysis on Implications of Democracy in Cambodia

Authors: Puthsodary Tat

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Democracy has been categorially accepted and used as foreign and domestic policy agendas for the hope of peace, economic growth and prosperity for more than 25 years in Cambodia. However, the country is now in the grip of dictatorship, human rights violations, and prospective economic sanctions. This paper examines different perceptions and experiences of democratic assistance. In this study, the author employs discourse theory, idealism and realism as a theory-based methodology for debating and assessing the implications of democratization. Discourse theory is used to establish a platform for understanding discursive formations, body of knowledge and the games of truth of democracy. Idealist approaches give rational arguments for adopting key tenets that work well on the ground. In contrast, realism allows for some sweeping critiques of utopian ideal and offers particular views on why Western hegemonic missions do not work well. From idealist views, the research finds that Cambodian people still believe that democracy is a prima facie universality for peace, growth and prosperity. From realism, democratization is on the brink of death in three reasons. Firstly, there are tensions between Western and local discourses about democratic values and norms. Secondly, democratic tenets have been undermined by the ruling party-controlled courts, corruption, structural oppression and political patronage-based institutions. The third pitfall is partly associated with foreign aid dependency and geopolitical power struggles in the region. Finally, the study offers a precise mosaic of democratic principles that may be used to avoid a future geopolitical and economic crisis.

Keywords: corruption, democracy, democratic principles, discourse theory, discursive formations, foreign aid dependency, games of truth, geopolitical and economic crisis, geopolitical power struggle, hegemonic mission, idealism, realism, utopian ideal

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853 Petrogenesis of the Neoproterozoic Rocks of Megele Area, Asosa, Western Ethiopia

Authors: Temesgen Oljira, Olugbenga Akindeji Okunlola, Akinade Shadrach Olatunji, Dereje Ayalew, Bekele Ayele Bedada

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The Western Ethiopian Shield (WES) is underlain by volcano-sedimentary terranes, gneissic terranes, and ophiolitic rocks intruded by different granitoid bodies. For the past few years, Neoproterozoic rocks of the Megele area in the western part of the WES have been explored. Understanding the geology of the area and assessing the mineralized area's economic potential requires petrological, geochemical, and geological characterization of the Neoproterozoic granitoids and associated metavolcanic rocks. Thus, the geological, geochemical, and petrogenetic features of Neoproterozoic granitoids and associated metavolcanic rocks were elucidated using a combination of field mapping, petrological, and geochemical study. The Megele area is part of a low-grade volcano-sedimentary zone that has been intruded by mafic (dolerite dyke) and granitoid intrusions (granodiorite, diorite, granite gneiss). The granodiorite, associated diorite, and granite gneiss are calc-alkaline, peraluminous to slightly metaluminous, S-type granitoids formed in volcanic arc subduction (VAG) to syn-collisional (syn-COLD) tectonic setting by fractionation of LREE-enriched, HREE-depleted basaltic magma with considerable crustal input. While the metabasalt is sub-alkaline (tholeiitic), metaluminous bodies are generated at the mid-oceanic ridge tectonic setting by partially melting HREE-depleted and LREE-enriched basaltic magma. The reworking of sediment-loaded crustal blocks at depth in a subduction zone resulted in the production of S-type granitoids. This basaltic magma was supplied from an LREE-enriched, HREE-depleted mantle.

Keywords: fractional crystallization, geochemistry, Megele, petrogenesis, s-type granite

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852 Association Type 1 Diabetes and Celiac Disease in Adult Patients

Authors: Soumaya Mrabet, Taieb Ach, Imen Akkari, Amira Atig, Neirouz Ghannouchi, Koussay Ach, Elhem Ben Jazia

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Introduction: Celiac disease (CD) and type 1 diabetes mellitus (T1D) are complex disorders with shared genetic components. The association between CD and T1D has been reported in many pediatric series. The aim of our study is to describe the epidemiological, clinical and evolutive characteristics of adult patients presenting this association. Material and Methods: This is a retrospective study including patients diagnosed with CD and T1D, explored in Internal Medicine, Gastroenterology and Endocrinology and Diabetology Departments of the Farhat Hached University Hospital, between January 2005 and June 2016. Results: Among 57 patients with CD, 15 patients had also T1D (26.3%). There are 11 women and 4 men with a median age of 27 years (16-48). All patients developed T1D prior to the diagnosis of CD with an average duration of 47 months between the two diagnosis (6 months-5 years). CD was revealed by recurrent abdominal pain in 11 cases, diarrhea in 10 cases, bloating in 8 cases, constipation in 6 cases and vomiting in 2 cases. Three patients presented cycle disorders with secondary amenorrhea in 2 patients. Anti-Endomysium, anti-transglutaminase and Anti-gliadin antibodies were positive respectively in 57, 54 and 11 cases. The biological tests revealed anemia in 10 cases, secondary to iron deficiency in 6 cases and folate and vitamin B12 deficiency in 4 cases, hypoalbuminaemia in 4 cases, hypocalcemia in 3 cases and hypocholesterolemia in 1 patient. Upper gastrointestinal endoscopy showed an effacement of the folds of the duodenal mucosa in 6 cases and a congestive duodenal mucosa in 3 cases. The macroscopic appearance was normal in the others cases. Microscopic examination showed an aspect of villous atrophy in 57 cases, which was partial in 10 cases and total in 47 cases. After an average follow-up of 3 years 2 months, the evolution was favorable in all patients under gluten-free diet with the necessity of less important doses of insulin in 10 patients. Conclusion: In our study, the prevalence of T1D in adult patients with CD was 26.3%. This association can be attributed to overlapping genetic HLA risk loci. In recent studies, the role of gluten as an important player in the pathogenesis of CD and T1D has been also suggested.

Keywords: celiac disease, gluten, prevalence, type 1 diabetes

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851 Optimization of Acid Treatments by Assessing Diversion Strategies in Carbonate and Sandstone Formations

Authors: Ragi Poyyara, Vijaya Patnana, Mohammed Alam

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When acid is pumped into damaged reservoirs for damage removal/stimulation, distorted inflow of acid into the formation occurs caused by acid preferentially traveling into highly permeable regions over low permeable regions, or (in general) into the path of least resistance. This can lead to poor zonal coverage and hence warrants diversion to carry out an effective placement of acid. Diversion is desirably a reversible technique of temporarily reducing the permeability of high perm zones, thereby forcing the acid into lower perm zones. The uniqueness of each reservoir can pose several challenges to engineers attempting to devise optimum and effective diversion strategies. Diversion techniques include mechanical placement and/or chemical diversion of treatment fluids, further sub-classified into ball sealers, bridge plugs, packers, particulate diverters, viscous gels, crosslinked gels, relative permeability modifiers (RPMs), foams, and/or the use of placement techniques, such as coiled tubing (CT) and the maximum pressure difference and injection rate (MAPDIR) methodology. It is not always realized that the effectiveness of diverters greatly depends on reservoir properties, such as formation type, temperature, reservoir permeability, heterogeneity, and physical well characteristics (e.g., completion type, well deviation, length of treatment interval, multiple intervals, etc.). This paper reviews the mechanisms by which each variety of diverter functions and discusses the effect of various reservoir properties on the efficiency of diversion techniques. Guidelines are recommended to help enhance productivity from zones of interest by choosing the best methods of diversion while pumping an optimized amount of treatment fluid. The success of an overall acid treatment often depends on the effectiveness of the diverting agents.

Keywords: diversion, reservoir, zonal coverage, carbonate, sandstone

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850 Assessing Solid Waste Management Practices and Health Impacts in Port Harcourt City, Nigeria

Authors: Perpetual Onyejelem, Kenichi Matsui

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Solid waste management has recently posed urgent challenges to environmental sustainability and public health in emerging Sub-Saharan urban centers. This paper examines solid waste management in Port Harcourt, the rapidly growing city in Nigeria, with a focus on current solid waste management practices and its health implications. To do so we analyzed past academic papers and official documents. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement and its four-stage inclusion/exclusion criteria were utilized as part of a systematic literature review technique to identify papers related to solid waste management practices (Scopus and Google Scholar). In terms of policy documents, we focused on information about the implementation between 2014 and 2023. We found that the Rivers State Waste Management Policy and the National Policy on Solid Waste Management were the two most important documents to understand Port Harcourt’s practices. Past studies, however, highlighted that residents continued to dump waste in drainages as they were largely unaware of the policies that encourage them to sort waste. The studies tend to blame the city of its lack of political commitment to monitoring waste sites. Another study highlighted inefficient waste collection practices, the absence of community participation and poor resident awareness of 3R practices. Government documents and past studies tend to agree that an increase in disorderly waste management practices and the emergence of vector-borne diseases (e.g., malaria, lassa fever, cholera) co-incided in Port Harcourt. This led to increased spending for healthcare for locals, particularly low-income households. This study concludes by making some remedial recommendations.

Keywords: health effects, solid waste management practices, environmental pollution, Port Harcourt

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849 Selecting Graduates for the Interns’ Award by Using Multisource Feedback Process: Does It Work?

Authors: Kathryn Strachan, Sameer Otoom, Amal AL-Gallaf, Ahmed Al Ansari

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Introduction: Introducing a reliable method to select graduates for an award in higher education can be challenging but is not impossible. Multisource feedback (MSF) is a popular assessment tool that relies on evaluations of different groups of people, including physicians and non-physicians. It is useful for assessing several domains, including professionalism, communication and collaboration and may be useful for selecting the best interns to receive a University award. Methods: 16 graduates responded to an invitation to participate in the student award, which was conducted by the Royal College of Surgeons of Ireland-Bahrain Medical University of Bahrain (RCSI Bahrain) using the MSF process. Five individuals from the following categories rated each participant: physicians, nurses, and fellow students. RCSI Bahrain graduates were assessed in the following domains; professionalism, communication, and collaboration. Mean and standard deviation were calculated and the award was given to the graduate who scored the highest among his/her colleagues. Cronbach’s coefficient was used to determine the questionnaire’s internal consistency and reliability. Factor analysis was conducted to examine for the construct validity. Results: 16 graduates participated in the RCSI-Bahrain interns’ award based on the MSF process, giving us a 16.5% response rate. The instrument was found to be suitable for factor analysis and showed 3 factor solutions representing 79.3% of the total variance. Reliability analysis using Cronbach’s α reliability of internal consistency indicated that the full scale of the instrument had high internal consistency (Cronbach’s α 0.98). Conclusion: This study found the MSF process to be reliable and valid for selecting the best graduates for the interns’ awards. However, the low response rates may suggest that the process is not feasible for allowing the majority of the students to participate in the selection process. Further research studies may be required to support the feasibility of the MSF process in selecting graduates for the university award.

Keywords: MSF, RCSI, validity, Bahrain

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848 Practice Educators' Perspective: Placement Challenges in Social Work Education in England

Authors: Yuet Wah Echo Yeung

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Practice learning is an important component of social work education. Practice educators are charged with the responsibility to support and enable learning while students are on placement. They also play a key role in teaching students to integrate theory and practice, as well as assessing their performance. Current literature highlights the structural factors that make it difficult for practice educators to create a positive learning environment for students. Practice educators find it difficult to give sufficient attention to their students because of the lack of workload relief, the increasing emphasis on managerialism and bureaucratisation, and a range of competing organisational and professional demands. This paper reports the challenges practice educators face and how they manage these challenges in this context. Semi-structured face-to-face interviews were conducted with thirteen practice educators who support students in statutory and voluntary social care settings in the Northwest of England. Interviews were conducted between April and July 2017 and each interview lasted about 40 minutes. All interviews were recorded and transcribed. All practice educators are experienced social work practitioners with practice experience ranging from 6 to 42 years. On average they have acted as practice educators for 13 years and all together have supported 386 students. Our findings reveal that apart from the structural factors that impact how practice educators perform their roles, they also faced other challenges when supporting students on placement. They include difficulty in engaging resistant students, complexity in managing power dynamics in the context of practice learning, and managing the dilemmas of fostering a positive relationship with students whilst giving critical feedback. Suggestions to enhance the practice educators’ role include support from organisations and social work teams; effective communication with university tutors, and a forum for practice educators to share good practice and discuss placement issues.

Keywords: social work education, placement challenges, practice educator, practice learning

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847 A Mixed Method Approach Investigating EFL Teachers' Beliefs and Practices towards Classroom-Based Assessment in Saudi Higher Educational Institutions

Authors: Mashael AlSalem

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While research into language assessment has expanded in recent years, few if any studies to date have targeted the nature of thought processes used by teachers when constructing classroom-based assessment. This study reports on teachers’ conceptions of English grammar assessment and their classroom assessment practices in their Saudi higher educational facilities. A mixed-method approach using both qualitative and quantitative research instruments was employed to elicit teachers’ perceptions of English grammar assessment and their relationship to their current practices. Participants of the study included EFL teachers from 4 different educational facilities: King Saudi University, Princess Noura University, Imam Mouhamed Islamic University, and Institute of Public Administration. Data collection involved questionnaire (N=100), semi-structured interviews (N=30), retrospective thinking (N=20), and document analysis (N=20). Activity theory is used as an interpretive framework to explore and investigate the entire system of constructing classroom-based assessment. Preliminary findings reveal several similarities and differences between the participants’ stated beliefs and their current practices of assessing English grammar. Findings also showed that teacher participant’s beliefs about how English grammar should be assessed are influenced mostly by prior learning experience as well as their teaching instruction practices. Their practices, on the other hand, was more guided by educational policies and lack of teacher training in the field of assessment, among other factors. This research makes a significant contribution to knowledge in three different areas: it enriches the literature on language teacher cognition; it builds on the body of research on language classroom assessment, and it expands on the possibilities to use AC to investigate the relationship between teachers’ beliefs and practices.

Keywords: activity theory, classroom-based assessment, language teacher cognition, mixed method approach

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846 Hybrid Renewable Energy System Development Towards Autonomous Operation: The Deployment Potential in Greece

Authors: Afroditi Zamanidou, Dionysios Giannakopoulos, Konstantinos Manolitsis

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A notable amount of electrical energy demand in many countries worldwide is used to cover public energy demand for road, square and other public spaces’ lighting. Renewable energy can contribute in a significant way to the electrical energy demand coverage for public lighting. This paper focuses on the sizing and design of a hybrid energy system (HES) exploiting the solar-wind energy potential to meet the electrical energy needs of lighting roads, squares and other public spaces. Moreover, the proposed HES provides coverage of the electrical energy demand for a Wi-Fi hotspot and a charging hotspot for the end-users. Alongside the sizing of the energy production system of the proposed HES, in order to ensure a reliable supply without interruptions, a storage system is added and sized. Multiple scenarios of energy consumption are assumed and applied in order to optimize the sizing of the energy production system and the energy storage system. A database with meteorological prediction data for 51 areas in Greece is developed in order to assess the possible deployment of the proposed HES. Since there are detailed meteorological prediction data for all 51 areas under investigation, the use of these data is evaluated, comparing them to real meteorological data. The meteorological prediction data are exploited to form three hourly production profiles for each area for every month of the year; minimum, average and maximum energy production. The energy production profiles are combined with the energy consumption scenarios and the sizing results of the energy production system and the energy storage system are extracted and presented for every area. Finally, the economic performance of the proposed HES in terms of Levelized cost of energy is estimated by calculating and assessing construction, operation and maintenance costs.

Keywords: energy production system sizing, Greece’s deployment potential, meteorological prediction data, wind-solar hybrid energy system, levelized cost of energy

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845 Prediction Study of a Corroded Pressure Vessel Using Evaluation Measurements and Finite Element Analysis

Authors: Ganbat Danaa, Chuluundorj Puntsag

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The steel structures of the Oyu-Tolgoi mining Concentrator plant are corroded during operation, which raises doubts about the continued use of some important structures of the plant, which is one of the problems facing the plant's regular operation. As a part of the main operation of the plant, the bottom part of the pressure vessel, which plays an important role in the reliable operation of the concentrate filter-drying unit, was heavily corroded, so it was necessary to study by engineering calculations, modeling, and simulation using modern advanced engineering programs and methods. The purpose of this research is to investigate whether the corroded part of the pressure vessel can be used normally in the future using advanced engineering software and to predetermine the remaining life of the time of the pressure vessel based on engineering calculations. When the thickness of the bottom part of the pressure vessel was thinned by 0.5mm due to corrosion detected by non-destructive testing, finite element analysis using ANSYS WorkBench software was used to determine the mechanical stress, strain and safety factor in the wall and bottom of the pressure vessel operating under 2.2 MPa working pressure, made conclusions on whether it can be used in the future. According to the recommendations, by using sand-blast cleaning and anti-corrosion paint, the normal, continuous and reliable operation of the Concentrator plant can be ensured, such as ordering new pressure vessels and reducing the installation period. By completing this research work, it will be used as a benchmark for assessing the corrosion condition of steel parts of pressure vessels and other metallic and non-metallic structures operating under severe conditions of corrosion, static and dynamic loads, and other deformed steels to make analysis of the structures and make it possible to evaluate and control the integrity and reliable operation of the structures.

Keywords: corrosion, non-destructive testing, finite element analysis, safety factor, structural reliability

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844 Classification of Factors Influencing Buyer-Supplier Relationship: A Case Study from the Cement Industry

Authors: Alberto Piatto, Zaza Nadja Lee Hansen, Peter Jacobsen

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This paper examines the quantitative and qualitative factors influencing the buyer-supplier relationship. Understanding and acting on the right factors influencing supplier relationship management is crucial when a company outsource an important part of its business as it can be for engineering to order (ETO) company executing only the designing part in-house. Acting on these factors increase the quality of the relationship obtaining for both parties what they want and expect from an improved relationship. Best practices in supplier relationship management are considered and a case study of a large global company, called Cement A/S, operating in the cement business is carried out. One study is conducted including a large international company and hundreds of its suppliers. Data from the company is collected using semi-structured interviews and data from the suppliers is collected using a survey. Based on these inputs and an extensive literature review a classification of factors influencing the relationship buyer-supplier is presented and discussed. The results show that different managers among the company are assessing supplier from various perspectives, a standard approach to measure the performance of suppliers does not exist. The factors used nowadays in the company to measure performances of the suppliers are mostly related to time and cost. Quality is a key factor, but it has not been addressed properly since no data are available in the system. From a practical perspective, managers can learn from this paper which factors to consider when applying best practices of Supplier Relationship Management. Furthermore, from a theoretical perspective, this paper contributes with new knowledge in the area as limited research in collaboration with the company has been conducted. For this reason, a company, its suppliers and few studies for this type of industry have been conducted. For further research, it is suggested to define the correlation of factors to the profitability of the company and calculate its impact. When conducting this analysis it is important to focus on the efficient and effective use of factors that can be measurable and accepted from the supplier.

Keywords: buyer-supplier relationship, cement industry, classification of factors, ETO

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843 Effects of Cacao Agroforestry and Landscape Composition on Farm Biodiversity and Household Dietary Diversity

Authors: Marlene Yu Lilin Wätzold, Wisnu Harto Adiwijoyo, Meike Wollni

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Land-use conversion from tropical forests to cash crop production in the form of monocultures has drastic consequences for biodiversity. Meanwhile, high dependence on cash crop production is often associated with a decrease in other food crop production, thereby affecting household dietary diversity. Additionally, deforestation rates have been found to reduce households’ dietary diversity, as forests often offer various food sources. Agroforestry systems are seen as a potential solution to improve local biodiversity as well as provide a range of provisioning ecosystem services, such as timber and other food crops. While a number of studies have analyzed the effects of agroforestry on biodiversity, as well as household livelihood indicators, little is understood between potential trade-offs or synergies between the two. This interdisciplinary study aims to fill this gap by assessing cacao agroforestry’s role in enhancing local bird diversity, as well as farm household dietary diversity. Additionally, we will take a landscape perspective and investigate in what ways the landscape composition, such as the proximity to forests and forest patches, are able to contribute to the local bird diversity, as well as households’ dietary diversity. Our study will take place in two agro-ecological zones in Ghana, based on household surveys of 500 cacao farm households. Using a subsample of 120 cacao plots, we will assess the degree of shade tree diversity and density using drone flights and a computer vision tree detection algorithm. Bird density and diversity will be assessed using sound recordings that will be kept in the cacao plots for 24 hours. Landscape compositions will be assessed via remote sensing images. The results of our study are of high importance as they will allow us to understand the effects of agroforestry and landscape composition in improving simultaneous ecosystem services.

Keywords: agroforestry, biodiversity, landscape composition, nutrition

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842 BIM4Cult Leveraging BIM and IoT for Enhancing Fire Safety in Historical Buildings

Authors: Anastasios Manos, Despina Elisabeth Filippidou

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Introduction: Historical buildings are an inte-gral part of the cultural heritage of every place, and beyond the obvious need for protection against risks, they have specific requirements regarding the handling of hazards and disasters such as fire, floods, earthquakes, etc. Ensuring high levels of protection and safety for these buildings is impera-tive for two distinct but interconnected reasons: a) they themselves constitute cultural heritage, and b) they are often used as museums/cultural spaces, necessitating the protection of both human life (vis-itors and workers) and the cultural treasures they house. However, these buildings present serious constraints in implementing the necessary measures to protect them from destruction due to their unique architecture, construction methods, and/or the structural materials used in the past, which have created an existing condition that is sometimes challenging to reshape and operate within the framework of modern regulations and protection measures. One of the most devastating risks that threaten historical buildings is fire. Catastrophic fires demonstrate the need for timely evaluation of fire safety measures in historical buildings. Recog-nizing the criticality of protecting historical build-ings from the risk of fire, the Confederation of Fire Protection Associations in Europe (CFPA E) issued specific guidelines in 2013 (CFPA-E Guideline No 30:2013 F) for the fire protection of historical buildings at the European level. However, until now, few actions have been implemented towards leveraging modern technologies in the field of con-struction and maintenance of buildings, such as Building Information Modeling (BIM) and the Inter-net of Things (IoT), for the protection of historical buildings from risks like fires, floods, etc. The pro-ject BIM4Cult has bee developed in order to fill this gap. It is a tool for timely assessing and monitoring of the fire safety level of historical buildings using BIM and IoT technologies in an integrated manner. The tool serves as a decision support expert system for improving the fire safety of historical buildings by continuously monitoring, controlling and as-sessing critical risk factors for fire.

Keywords: Iot, fire, BIM, expert system

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841 Empowerment Means Decision-Making: How Does It Empower Women: Case of Slum Areas of Dhaka City, Bangladesh

Authors: Nurunnaher Nurunnaher

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This paper examines the impact of women’s participation in microcredit on women’s decision making in the slum areas of Dhaka city, Bangladesh. There is confusion in the literature about whether women’s empowerment is or is not a trickle down impact of poverty alleviation or household well-being, and the studies use more or less similar indicators to measure the status of household and the status of women. Studies very rarely conceptualize and operationalize the term ‘empowerment’ as the word is often used without proper care by policy makers and development practitioners instead of household wellbeing. Currently, decision making in many studies has been used as an indicator of women’s empowerment when assessing the impact of microcredit programs on women. Based on a qualitative and feminist study this paper operationalizes women’s empowerment through the development of a conceptual framework, the identification of assessment criteria and the development of proper indicators that guided the whole study. The testimonies of participants, both men and women, were the basis of exploration of women’s lived experiences, which is the most appropriate method to explore the impact of such programs on women’s empowerment. The study considers empowerment as a process that affects various levels of life and gender relationships. The study found that there is a positive change in women’s position in decision making when women have developed an independent economic base with credit money. However, predominantly, women’s decision making is shared with men with the final decision still in the men’s hands. It can be said that women’s microcredit participation has not significantly challenged the social norms, therefore it is not surprising that women who hand over credit to their husband rarely have any power in intra-household bargaining process. Nevertheless, overall it is evident that women are continuously struggling toward the freedom to have the authority over household, economic and personal matters. It is concluded that while making strategic choices or gaining empowerment requires several steps, women’s participation in decision-making has several implications on their lives and potentially challenges patriarchy.

Keywords: women, gender inequality/equality, decision making, empowerment, microcredit, slums, Dhaka, Bangladesh

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840 Assessment on the Improvement of the Quality of Life after One Year of Regular Physical Activity and Treatment in Patients with Postmenopausal Osteoporosis

Authors: Stoyanka Georgieva Vladeva, Elena Kirilova Kirilova, Nikola Kirilov Kirilov

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Summary: WHO (World Health Organization) recommends the elder people a certain amount of regular physical activity in order to prevent some of the health issues. Postmenopausal osteoporosis is one of the chronic diseases which requires the maintaining of regular physical activity. The regular activity combined with an adequate medical treatment greatly improves the quality of life of the patient. Objectives: Assessment of the effect of the regular physical activity recommended by WHO on the quality of life in patients with postmenopausal osteoporosis. Material and methods: For the period of one year 68 female patients treated with Denosumab have been monitored. The bone density has been measured with the DEXA method in accordance to the T-score. No patients having any oncologic diseases and secondary osteoporosis have been included in the study. The subjects have been divided into groups by their age. The first group – women aged under 65 years (27 subjects) and the second group – women aged over 65 years (41 subjects). All patients have been advised to maintain regular physical activity included in the recommendations of the WHO in accordance with the age and the disease. The quality of life has been assessed in the beginning and at the end of the one-year period using the SF 36V2 questionnaire. Results: Only 31% of the subjects have engaged into regular increased physical activities for the whole period. Among them are mostly patients of the second group (aged over 65 years, 71%). The women from the both groups who were engaging into regular activities for this one-year period all experience an improvement of the quality of life. These results show that older patients understand the necessity of the physical activity for their health. The comparison of the output data to the scales of physical activity, durability, body pain, vitality, social activity and emotional stability has found an improvement at the end of the period in all patients. The osteodensitometry showed general improvement of the T-score. Patients with additional visits to their rheumatologist have better results. Conclusion: Combination of regular physical activity in accordance to the recommendations of WHO and medical treatment including anti-osteoporotic drugs improves the quality of life of women with postmenopausal osteoporosis.

Keywords: elderly patients, osteoporosis, physical activity, quality of life

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839 Dermatomyositis: It is Not Always an Allergic Reaction

Authors: Irfan Abdulrahman Sheth, Sohil Pothiawala

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Dermatomyositis is an idiopathic inflammatory myopathy, traditionally characterized by a progressive, symmetrical proximal muscle weakness and pathognomonic or characteristic cutaneous manifestations. We report a case of a 60-year old Chinese female who was referred from polyclinic for allergic rash over the body after applying hair dye 3 weeks ago. It was associated with puffiness of face, shortness of breath and hoarse voice since last 2 weeks with decrease effort tolerance. She also complained of dysphagia/ myalgia with progressive weakness of proximal muscles and palpitations. She denied chest pain, loss of appetite, weight loss, orthopnea or fever. She had stable vital signs and appeared cushingoid. She was noted to have rash over the scalp/ face and ecchymosis over the right arm with puffiness of face and periorbital oedema. There was symmetrical muscle weakness and other neurological examination was normal. Initial impression was of allergic reaction and underlying nephrotic syndrome and Cushing’s syndrome from TCM use. Diagnostic tests showed high Creatinine kinase (CK) of 1463 u/l, CK–MB of 18.7 ug/l and Troponin –T of 0.09 ug/l. The Full blood count and renal panel was normal. EMG showed inflammatory myositis. Patient was managed by rheumatologist and discharged on oral prednisolone with methotrexate/ ergocalciferol capsule and calcium carb, vitamin D tablets and outpatient follow up. In some patients, cutaneous disease exists in the absence of objective evidence of muscle inflammation. Management of dermatomyositis begins with careful investigation for the presence of muscle disease or of additional systemic involvement, particularly of the pulmonary, cardiac or gastrointestinal systems, and for the possibility of an accompanying malignancy. Muscle disease and systemic involvement can be refractory and may require multiple sequential therapeutic interventions or, at times, combinations of therapies. Thus, we want to highlight to the physicians that the cutaneous disease of dermatomyositis should not be confused with allergic reaction. It can be particularly challenging to diagnose. Early recognition aids appropriate management of this group of patients.

Keywords: dermatomyositis, myopathy, allergy, cutaneous disease

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838 Growth Pattern, Condition Factor and Relative Condition Factor of Twenty Important Demersal Marine Fish Species in Nigerian Coastal Water

Authors: Omogoriola Hannah Omoloye

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Fish is a key ingredient on the global menu, a vital factor in the global environment and an important basis for livelihood worldwide1. The length – weight relationships (LWRs) is of great importance in fishery assessment2,3. Its importance is pronounced in estimated the average weight at a given length group4 and in assessing the relative well being of a fish population5. Length and weight measurement in conjunction with age data can give information on the stock composition, age at maturity, life span, mortality, growth and production4,5,6,7. In addition, the data on length and weight can also provides important clues to climatic and environmental changes and the change in human consumption practices8,9. However, the size attained by the individual fish may also vary because of variation in food supply, and these in turn may reflect variation in climatic parameters and in the supply of nutrient or in the degree of competition for food. Environment deterioration, for example, may reduce growth rates and will cause a decrease in the average age of the fish. The condition factor and the relative condition factor10 are the quantitative parameters of the well being state of the fish and reflect recent feeding condition of the fish. It is based on the hypothesis that heavier fish of a given length are in better condition11. This factor varies according to influences of physiological factors, fluctuating according to different stages of the development. Condition factor has been used as an index of growth and feeding intensity12. Condition factor decrease with increase in length 12,13 and also influences the reproductive cycle in fish14. The objective here is to determine the length-weight relationships and condition factor for direct use in fishery assessment and for future comparisons between populations of the same species at different locations. To provide quantitative information on the biology of marine fish species trawl from Nigeria coastal water.

Keywords: condition factor, growth pattern, marine fish species, Nigerian Coastal water

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837 PlayTrain: A Research and Intervention Project for Early Childhood Teacher Education

Authors: Dalila Lino, Maria Joao Hortas, Carla Rocha, Clarisse Nunes, Natalia Vieira, Marina Fuertes, Kátia Sa

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The value of play is recognized worldwide and is considered a fundamental right of all children, as defined in Article 31 of the United Nations Children’s Rights. It is consensual among the scientific community that play, and toys are of vital importance for children’s learning and development. Play promotes the acquisition of language, enhances creativity and improves social, affective, emotional, cognitive and motor development of young children. Young children ages 0 to 6 who have had many opportunities to get involved in play show greater competence to adapt to new and unexpected situations and more easily overcome the pain and suffering caused by traumatic situations. The PlayTrain Project aims to understand the places/spaces of play in the education of children from 0 to 6 years and promoting the training of preschool teachers to become capable of developing practices that enhance children’s agency, experimentation in the physical and social world and the development of imagination and creativity. This project follows the Design-Based-Research (DBR) and has two dimensions: research and intervention. The participants are 120 students from the Master in Pre-school Education of the Higher School of Education, Polytechnic Institute of Lisbon enrolled in the academic year 2018/2019. The development of workshops focused on the role of play and toys for young children’s learning promotes the participants reflection and the development of skills and knowledge to construct developmentally appropriated practices in early childhood education. Data was collected through an online questionnaire and focal groups. Results show that the PlayTrain Project contribute to the development of a body of knowledge about the role of play for early childhood education. It was possible to identify the needs of preschool teacher education and to enhance the discussion among the scientific and academic community about the importance of deepening the role of play and toys in the study plans of the masters in pre-school education.

Keywords: children's learning, early childhood education, play, teacher education, toys

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836 Perception and Attitudes of Medical Students towards Dermatology as a Future Specialty.

Authors: Rakan Alajmi, Rahaf Alnazzawi, Yara Aljefri, Abdullah Alafif, Ali Alraddadi, Awadh Alamri

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Background: The distribution of physicians in different specialties across Saudi Arabia is determined by the career choices of medical students. Dermatology residency program is one of the highly competitive programs here in Saudi Arabia. Assessing and understanding the factors perceived to be attractive in choosing dermatology will aid the directors of the specialty programs to plan for a more balanced workforce distribution to better suit the needs of the specialties. Aim: The aim of our study is to determine and assess the factors perceived to be significantly attractive when choosing dermatology as a future specialty. Methods: The study is a cross-sectional study conducted in King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia. A validated questionnaire was sent electronically to clinical year medical students. In addition to the questionnaire, gender, grade point average, preferred specialty, and other socio-demographic data were assessed. Results: A total of 121 clinical years medical students completed the questionnaire, 8 (6.6%) preferred dermatology as a specialty. 76 (62.8%) of the participants score a grade point average of more than 4.5 and 83 students (68.6%) chose their specialty during clinical years. The appeal of being a dermatologist (P= 0.047), the portrayal of different specialities in the media (P= 0.005), and the likelihood that dermatologists can influence patients’ lives (P=0.010) were shown to be significantly attractive factors. Conclusion: There are many factors that are affecting students’ choices when choosing a medical specialty. The appeal of being a dermatologist, the portrayal of different specialities in the media, and the likelihood that dermatologists can influence patients’ lives were shown to be significantly attractive factors when choosing dermatology as a future specialty. Recognizing medical students’ specialty perception will lead them to a proper specialty tailored to their needs.

Keywords: dermatology, career choice, medical specialties, student's perception

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835 Assessing the Benefits of Super Depo Sutorejo as a Model of integration of Waste Pickers in a Sustainable City Waste Management

Authors: Yohanes Kambaru Windi, Loetfia Dwi Rahariyani, Dyah Wijayanti, Eko Rustamaji

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Surabaya, the second largest city in Indonesia, has been struggling for years with waste production and its management. Nearly 11,000 tons of waste are generated daily by domestic, commercial and industrial areas. It is predicted that approximately 1,300 tons of waste overflew the Benowo Landfill daily in 2013 and projected that the landfill operation will be critical in 2015. The Super Depo Sutorejo (SDS) is a pilot project on waste management launched by the government of Surabaya in March 2013. The project is aimed to reduce the amount of waste dumped in landfill by sorting the recyclable and organic waste for composting by employing waste pickers to sort the waste before transported to landfill. This study is intended to assess the capacity of SDS to process and reduce waste and its complementary benefits. It also overviews the benefits of the project to the waste pickers in term of satisfaction to the job. Waste processing data-sheets were used to assess the difference between input and outputs waste. A survey was distributed to 30 waste pickers and interviews were conducted as a further insight on a particular issue. The analysis showed that SDS enable to reduce waste up to 50% before dumped in the final disposal area. The cost-benefits analysis using cost differential calculation revealed the economic benefit is considerable low, but composting may substitute tangible benefits for maintain the city’s parks. Waste pickers are mostly satisfied with their job (i.e. Salary, health coverage, job security), services and facilities available in SDS and enjoyed rewarding social life within the project. It is concluded that SDS is an effective and efficient model for sustainable waste management and reliable to be developed in developing countries. It is a strategic approach to empower and open up working opportunity for the poor urban community and prolong the operation of landfills.

Keywords: cost-benefits, integration, satisfaction, waste management

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834 Viscoelastic Characterization of Gelatin/Cellulose Nanocrystals Aqueous Bionanocomposites

Authors: Liliane Samara Ferreira Leite, Francys Kley Vieira Moreira, Luiz Henrique Capparelli Mattoso

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The increasing environmental concern regarding the plastic pollution worldwide has stimulated the development of low-cost biodegradable materials. Proteins are renewable feedstocks that could be used to produce biodegradable plastics. Gelatin, for example, is a cheap film-forming protein extracted from animal skin and connective tissues of Brazilian Livestock residues; thus it has a good potential in low-cost biodegradable plastic production. However, gelatin plastics are limited in terms of mechanical and barrier properties. Cellulose nanocrystals (CNC) are efficient nanofillers that have been used to extend physical properties of polymers. This work was aimed at evaluating the reinforcing efficiency of CNC on gelatin films. Specifically, we have employed the continuous casting as the processing method for obtaining the gelatin/CNC bionanocomposites. This required a first rheological study for assessing the effect of gelatin-CNC and CNC-CNC interactions on the colloidal state of the aqueous bionanocomposite formulations. CNC were isolated from eucalyptus pulp by sulfuric acid hydrolysis (65 wt%) at 55 °C for 30 min. Gelatin was solubilized in ultra-pure water at 85°C for 20 min and then mixed with glycerol at 20 wt.% and CNC at 0.5 wt%, 1.0 wt% and 2.5 wt%. Rotational measurements were performed to determine linear viscosity (η) of bionanocomposite solutions, which increased with increasing CNC content. At 2.5 wt% CNC, η increased by 118% regarding the neat gelatin solution, which was ascribed to percolation CNC network formation. Storage modulus (G’) and loss modulus (G″) further determined by oscillatory tests revealed that a gel-like behavior was dominant in the bionanocomposite solutions (G’ > G’’) over a broad range of temperature (20 – 85 °C), particularly at 2.5 wt% CNC. These results confirm effective interactions in the aqueous gelatin-CNC bionanocomposites that could substantially increase the physical properties of the gelatin plastics. Tensile tests are underway to confirm this hypothesis. The authors would like to thank the Fapesp (process n 2016/03080-3) for support.

Keywords: bionanocomposites, cellulose nanocrystals, gelatin, viscoelastic characterization

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833 Assessing the Macroeconomic Effects of Fiscal Policy Changes in Egypt: A Bayesian Structural Vector Autoregression Approach

Authors: Walaa Diab, Baher Atlam, Nadia El Nimer

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Egypt faces many obvious economic challenges, and it is so clear that a real economic transformation is needed to address those problems, especially after the recent decisions of floating the Egyptian pound and the gradual subsidy cuts that are trying to meet the needed conditions to get the IMF support of (a £12bn loan) for its economic reform program. Following the post-2008 revival of the interest in the fiscal policy and its vital role in speeding up or slowing down the economic growth. Here comes the value of this paper as it seeks to analyze the macroeconomic effects of fiscal policy in Egypt by applying A Bayesian SVAR Approach. The study uses the Bayesian method because it includes the prior information and no relevant information is omitted and so it is well suited for rational, evidence-based decision-making. Since the study aims to define the effects of fiscal policy shocks in Egypt to help the decision-makers in determining the proper means to correct the structural problems in the Egyptian economy, it has to study the period of 1990s economic reform, but unfortunately; the available data is on an annual frequency. Thus, it uses annual time series to study the period 1991: 2005 And quarterly data over the period 2006–2016. It uses a set of six main variables includes government expenditure and net tax revenues as fiscal policy arms affecting real GDP, unemployment, inflation and the interest rate. The study also tries to assess the 'crowding out' effects by considering the effects of government spending and government revenue shocks on the composition of GDP, namely, on private consumption and private investment. Last but not least the study provides its policy implications regarding the needed role of fiscal policy in Egypt in the upcoming economic reform building on the results it concludes from the previous reform program.

Keywords: fiscal policy, government spending, structural vector autoregression, taxation

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832 Establishing a Surrogate Approach to Assess the Exposure Concentrations during Coating Process

Authors: Shan-Hong Ying, Ying-Fang Wang

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A surrogate approach was deployed for assessing exposures of multiple chemicals at the selected working area of coating processes and applied to assess the exposure concentration of similar exposed groups using the same chemicals but different formula ratios. For the selected area, 6 to 12 portable photoionization detector (PID) were placed uniformly in its workplace to measure its total VOCs concentrations (CT-VOCs) for 6 randomly selected workshifts. Simultaneously, one sampling strain was placed beside one of these portable PIDs, and the collected air sample was analyzed for individual concentration (CVOCi) of 5 VOCs (xylene, butanone, toluene, butyl acetate, and dimethylformamide). Predictive models were established by relating the CT-VOCs to CVOCi of each individual compound via simple regression analysis. The established predictive models were employed to predict each CVOCi based on the measured CT-VOC for each the similar working area using the same portable PID. Results show that predictive models obtained from simple linear regression analyses were found with an R2 = 0.83~0.99 indicating that CT-VOCs were adequate for predicting CVOCi. In order to verify the validity of the exposure prediction model, the sampling analysis of the above chemical substances was further carried out and the correlation between the measured value (Cm) and the predicted value (Cp) was analyzed. It was found that there is a good correction between the predicted value and measured value of each measured chemical substance (R2=0.83~0.98). Therefore, the surrogate approach could be assessed the exposure concentration of similar exposed groups using the same chemicals but different formula ratios. However, it is recommended to establish the prediction model between the chemical substances belonging to each coater and the direct-reading PID, which is more representative of reality exposure situation and more accurately to estimate the long-term exposure concentration of operators.

Keywords: exposure assessment, exposure prediction model, surrogate approach, TVOC

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831 AI-Based Techniques for Online Social Media Network Sentiment Analysis: A Methodical Review

Authors: A. M. John-Otumu, M. M. Rahman, O. C. Nwokonkwo, M. C. Onuoha

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Online social media networks have long served as a primary arena for group conversations, gossip, text-based information sharing and distribution. The use of natural language processing techniques for text classification and unbiased decision-making has not been far-fetched. Proper classification of this textual information in a given context has also been very difficult. As a result, we decided to conduct a systematic review of previous literature on sentiment classification and AI-based techniques that have been used in order to gain a better understanding of the process of designing and developing a robust and more accurate sentiment classifier that can correctly classify social media textual information of a given context between hate speech and inverted compliments with a high level of accuracy by assessing different artificial intelligence techniques. We evaluated over 250 articles from digital sources like ScienceDirect, ACM, Google Scholar, and IEEE Xplore and whittled down the number of research to 31. Findings revealed that Deep learning approaches such as CNN, RNN, BERT, and LSTM outperformed various machine learning techniques in terms of performance accuracy. A large dataset is also necessary for developing a robust sentiment classifier and can be obtained from places like Twitter, movie reviews, Kaggle, SST, and SemEval Task4. Hybrid Deep Learning techniques like CNN+LSTM, CNN+GRU, CNN+BERT outperformed single Deep Learning techniques and machine learning techniques. Python programming language outperformed Java programming language in terms of sentiment analyzer development due to its simplicity and AI-based library functionalities. Based on some of the important findings from this study, we made a recommendation for future research.

Keywords: artificial intelligence, natural language processing, sentiment analysis, social network, text

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830 Performance of Rural and Urban Adult Participants on Neuropsychological Tests in Zambia

Authors: Happy Zulu

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Neuropsychological examination is an important way of formally assessing brain function. While there is so much documentation about the influence that some factors, such as age and education, have on neuropsychological tests (NP), not so much has been done to assess the influence that residency (rural/urban) may have. The specific objectives of this study were to establish if there is a significant difference in mean test scores on NP tests between rural and urban participants and to assess which tests on the Zambia Neurobehavioural Test Battery (ZNTB) are more affected by the participants‘ residency (rural/urban) and to determine the extent to which education, gender, and age predict test performance on NP tests for rural and urban participants. The participants (324) were drawn from both urban and rural areas of Zambia (Rural = 152 and Urban = 172). However, only 234 participants (Rural = 152 and Urban 82) were used for all the analyses in this particular study. The 234 participants were used as the actual proportion of the rural vs urban population in Zambia was 65% : 35%, respectively (CSO, 2003). The rural-urban ratio for the participants that were captured during the data collection process was 152 : 172, respectively. Thus, all the rural participants (152) were included and 90 of the 172 urban participants were randomly excluded so that the rural/urban ratio reached the desired 65% : 35 % which was the required ideal statistic for appropriate representation of the actual population in Zambia. Data on NP tests were analyzed from 234 participants, rural (N=152) reflecting 65% and urban (N=82) reflecting 35%. T-tests indicated that urban participants had superior performances in all the seven NP test domains, and all the mean differences in all these domains were found to be statistically significant. Residency had a large or moderate effect in five domains, while its effect size was small only in two of the domains. A standard multiple regression revealed that education, age and residency as predictor variables made a significant contribution to variance in performance on various domains of the ZNTB. However, the gender of participants was not a major factor in determining one‘s performance on neuropsychological tests. This particular report is part of an ongoing, larger, cutting-edge study aimed at formulating the normative data for Zambia with regard to performance on neuropsychological tests. This is necessary for appropriate, effective, and efficient assessment or diagnosis of various neurocognitive and neurobehavioural deficits that a number of people may currently be suffering from. It has been shown in this study that it is vital to make careful analyses of the variables that may be associated with one‘s performance on neuropsychological tests.

Keywords: neuropsychology, neurobehavioural, residency, Zambia

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829 A Foodborne Cholera Outbreak in a School Caused by Eating Contaminated Fried Fish: Hoima Municipality, Uganda, February 2018

Authors: Dativa Maria Aliddeki, Fred Monje, Godfrey Nsereko, Benon Kwesiga, Daniel Kadobera, Alex Riolexus Ario

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Background: Cholera is a severe gastrointestinal disease caused by Vibrio cholera. It has caused several pandemics. On 26 February 2018, a suspected cholera outbreak, with one death, occurred in School X in Hoima Municipality, western Uganda. We investigated to identify the scope and mode of transmission of the outbreak, and recommend evidence-based control measures. Methods: We defined a suspected case as onset of diarrhea, vomiting, or abdominal pain in a student or staff of School X or their family members during 14 February–10 March. A confirmed case was a suspected case with V. cholerae cultured from stool. We reviewed medical records at Hoima Hospital and searched for cases at School X. We conducted descriptive epidemiologic analysis and hypothesis-generating interviews of 15 case-patients. In a retrospective cohort study, we compared attack rates between exposed and unexposed persons. Results: We identified 15 cases among 75 students and staff of School X and their family members (attack rate=20%), with onset from 25-28 February. One patient died (case-fatality rate=6.6%). The epidemic curve indicated a point-source exposure. On 24 February, a student brought fried fish from her home in a fishing village, where a cholera outbreak was ongoing. Of the 21 persons who ate the fish, 57% developed cholera, compared with 5.6% of 54 persons who did not eat (RR=10; 95% CI=3.2-33). None of 4 persons who recooked the fish before eating, compared with 71% of 17 who did not recook it, developed cholera (RR=0.0, 95%CIFisher exact=0.0-0.95). Of 12 stool specimens cultured, 6 yielded V. cholerae. Conclusion: This cholera outbreak was caused by eating fried fish, which might have been contaminated with V. cholerae in a village with an ongoing outbreak. Lack of thorough cooking of the fish might have facilitated the outbreak. We recommended thoroughly cooking fish before consumption.

Keywords: cholera, disease outbreak, foodborne, global health security, Uganda

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828 A Longitudinal Examination of the Impact of Treatment Modality on Relationship Satisfaction and Mental Health Quality of Life Outcomes among Prostate Cancer Survivors

Authors: Gabriela Ilie, Robert D. H. Rutledge

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A review of the literature reveals a need for longitudinal studies to properly understand the quality of life of prostate cancer survivors during their prostate cancer journey in order to identify opportunities for patient support and care during prostate cancer survivorship. In this study, mental health and relationship satisfaction were assessed longitudinally and by treatment modality among a population-based sample of Canadian adult men with a history of prostate cancer diagnosis. A total of 98 men, aged 51 or older with a history of prostate cancer completed an on-line 15-minute survey between May 2017 and February 2018, assessing mental health (Kessler Psychological Distress Scale) and relationship satisfaction (Dyadic Adjustment Scale) at baseline and at three months post-treatment with either active or nonactive prostate cancer treatment. Almost 1 in 6 men in this sample screened positive for mental health issues (17.34%, n=17) irrespective of treatment modality and most (n=11) were not currently on medication for depression, anxiety or both. Mental health outcomes were poorer for men with multimorbidity. For every instance of screening positive for mental health issues, 2.021 (95% CI:1.1 to 3.8) times more comorbidities were recorded. Relationship satisfaction and dyadic cohesion were statistically significantly lower from first assessment to 3 months for men who underwent multiple treatment modalities (surgery and radiation with hormonal therapy). Relationship satisfaction was also lower at 3 months for men who underwent radiation therapy. Almost 1 in 2 men in this sample (74%) indicated they did not attend a prostate cancer support group. Results suggest that treatment for mental health is underutilized in men with prostate cancer. Men who undergo multiple forms of active treatment appear more vulnerable to relationship dissatisfaction and feeling disconnected from their partner. Data points to important opportunities for patient education and care support during survivorship.

Keywords: prostate cancer survivorship, mental health, quality of life, relationship satisfaction

Procedia PDF Downloads 111